Provider Demographics
NPI:1679453740
Name:NAVA, MAYRA (PHD)
Entity type:Individual
Prefix:DR
First Name:MAYRA
Middle Name:
Last Name:NAVA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6226 S MELVINA AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60638-4308
Mailing Address - Country:US
Mailing Address - Phone:773-242-0890
Mailing Address - Fax:
Practice Address - Street 1:6226 S MELVINA AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60638-4308
Practice Address - Country:US
Practice Address - Phone:773-242-0890
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-08
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1882884103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool