Provider Demographics
NPI:1902930647
Name:NAVA, MICHAEL (LCSW)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:NAVA
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 191
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90714-0191
Mailing Address - Country:US
Mailing Address - Phone:562-743-2789
Mailing Address - Fax:562-421-1496
Practice Address - Street 1:5199 E PACIFIC COAST HWY
Practice Address - Street 2:SUITE 615
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90804-3302
Practice Address - Country:US
Practice Address - Phone:562-743-2789
Practice Address - Fax:562-421-1496
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 211601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical