MEDICARE: MRS. VIOLETA AVAKYAN LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	LCSW67032	CA

General Provider Information

NPI Number	:	1184819047
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. VIOLETA AVAKYAN LCSW

Provider Business Mailing Address
First Line	:	11302 GLAMIS ST
Second Line	:
City	:	LAKE VIEW TERRACE
State	:	CA
Zip	:	91342-6534
Country	:	US
Telephone Number	:	818-523-8066
Fax Number	:

Provider Business Practice Location Address
First Line	:	222 S HILL ST STE 605
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90012-3506
Country	:	US
Telephone Number	:	213-922-8122
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/12/2007
Last Update Date	:	03/23/2023

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