JUSTIN SURACHAI TANYAVUTTI LPCC NPI 1538559166

NPI Information

NPI: 1538559166
Provider Name: JUSTIN SURACHAI TANYAVUTTI, LPCC
Classification: Counselor - 101YP2500X
Entity Type: Individual

Specialization: Professional

Address:
1918 BONITA AVE
BERKELEY, CA
ZIP 94704
Phone: (703) 261-9973
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Justin Surachai Tanyavutti, LPCC is a professional counselor in Berkeley, CA. Justin Surachai Tanyavutti, LPCC NPI is 1538559166. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1918 BONITA AVE
BERKELEY, CA
ZIP 94704
Phone: (703) 261-9973

The enumeration date for this NPI number is 2/3/2015 and was last updated on 9/16/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YP2500X	Counselor	Professional	178.010560	ILLINOIS	No
2	101YP2500X	Counselor	Professional	LPCC6651	CALIFORNIA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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