Provider Demographics
NPI:1275339996
Name:AYVAZIAN, VIKEN ALEXANDER (MS, LPC, NCC)
Entity type:Individual
Prefix:MR
First Name:VIKEN
Middle Name:ALEXANDER
Last Name:AYVAZIAN
Suffix:
Gender:
Credentials:MS, LPC, NCC
Other - Prefix:MR
Other - First Name:ALEX
Other - Middle Name:
Other - Last Name:AYVAZIAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, LPC, NCC
Mailing Address - Street 1:650 PONCE DE LEON AVE NE STE 300 #1401
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30308-1864
Mailing Address - Country:US
Mailing Address - Phone:626-373-3409
Mailing Address - Fax:
Practice Address - Street 1:650 PONCE DE LEON AVE NE STE 300 #1401
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308-1864
Practice Address - Country:US
Practice Address - Phone:626-373-3409
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-22
Last Update Date:2025-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC015462101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional