Individual provider · Type 1 NPI
Elham Ellie Mandavi Berenji
Addiction (Substance Use Disorder) Counselor · Georgetown, TX
NPI number
1912501941
Active
Practice location
121 Brunnen Way
Georgetown, TX 78626-2620
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Counselor | 101YM0800X | 82942 (TX) |
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | 15161 (TX) |
Addiction (Substance Use Disorder) Counselor: Definition to come...
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About NPI 1912501941
Elham Ellie Mandavi Berenji's National Provider Identifier is 1912501941, issued on Nov 30, 2020. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Georgetown, TX. The record was last updated on Nov 30, 2020.