Provider Demographics
NPI:1780242255
Name:HABASHI, MARIAM S
Entity type:Individual
Prefix:
First Name:MARIAM
Middle Name:S
Last Name:HABASHI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8795 RALSTON RD STE 110
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80002-2353
Mailing Address - Country:US
Mailing Address - Phone:720-696-0028
Mailing Address - Fax:225-208-1119
Practice Address - Street 1:8795 RALSTON RD STE 110
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80002-2353
Practice Address - Country:US
Practice Address - Phone:720-696-0028
Practice Address - Fax:225-208-1119
Is Sole Proprietor?:No
Enumeration Date:2019-05-30
Last Update Date:2025-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRBT-19-84425106S00000X
COMFTC.0014897106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician