Provider Demographics
NPI:1952091423
Name:MAYFIELD, KARAVEN MYA
Entity Type:Individual
Prefix:
First Name:KARAVEN
Middle Name:MYA
Last Name:MAYFIELD
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 1:2051 FLATSHOALS ROAD SE
Mailing Address - Street 2:APT. K9
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30316
Mailing Address - Country:US
Mailing Address - Phone:770-728-5318
Mailing Address - Fax:
Practice Address - Street 1:225 CEDAR HILL STREET
Practice Address - Street 2:SUITE 200
Practice Address - City:MARLBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01752
Practice Address - Country:US
Practice Address - Phone:857-829-4040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-09
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician