Provider Demographics
NPI:1194850230
Name:KHACHATRYAN, SUNNY NELLI (LMHC, CAP)
Entity type:Individual
Prefix:MISS
First Name:SUNNY
Middle Name:NELLI
Last Name:KHACHATRYAN
Suffix:
Gender:F
Credentials:LMHC, CAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19380 COLLINS AVE APT 712
Mailing Address - Street 2:
Mailing Address - City:SUNNY ISLES BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33160-2236
Mailing Address - Country:US
Mailing Address - Phone:954-634-4292
Mailing Address - Fax:954-634-4293
Practice Address - Street 1:19380 COLLINS AVE APT 712
Practice Address - Street 2:
Practice Address - City:SUNNY ISLES BEACH
Practice Address - State:FL
Practice Address - Zip Code:33160-2236
Practice Address - Country:US
Practice Address - Phone:954-634-4292
Practice Address - Fax:954-634-4293
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2015-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
FLMH13062101YP2500X
FLADC003081-2014101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)