Provider Demographics
NPI:1427463520
Name:KHOUCASIAN, SILVY (MA, MFTI)
Entity type:Individual
Prefix:MISS
First Name:SILVY
Middle Name:
Last Name:KHOUCASIAN
Suffix:
Gender:F
Credentials:MA, MFTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18550 BURBANK BLVD APT 223
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-2620
Mailing Address - Country:US
Mailing Address - Phone:818-438-8452
Mailing Address - Fax:
Practice Address - Street 1:18550 BURBANK BLVD APT 223
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-2620
Practice Address - Country:US
Practice Address - Phone:818-438-8452
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-26
Last Update Date:2014-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA75734101YM0800X
CAIMF75734101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health