MEDICARE: ADRINE BABAKHANYAN

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	101YM0800X	Mental Health Counselor	89799	CA
2	104100000X	Social Worker	89799	CA
3	1041C0700X	Clinical Social Worker	118014	CA

General Provider Information

NPI Number	:	1548788532
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADRINE BABAKHANYAN

Provider Business Mailing Address
First Line	:	PO BOX 9594
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91226-0594
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	237 N CENTRAL AVE
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91203-3526
Country	:	US
Telephone Number	:	818-547-9544
Fax Number	:

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

Provider Enumeration Date	:	08/30/2017
Last Update Date	:	09/20/2023

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Directions to “ ADRINE BABAKHANYAN ” Practice Location

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