Provider Demographics
NPI:1164182689
Name:GIVENS, MEHKYE ASSYRIAN (NMD, LEHP, SMN, OLO)
Entity type:Individual
Prefix:DR
First Name:MEHKYE
Middle Name:ASSYRIAN
Last Name:GIVENS
Suffix:
Gender:F
Credentials:NMD, LEHP, SMN, OLO
Other - Prefix:DR
Other - First Name:SELAH
Other - Middle Name:ASHERAH
Other - Last Name:GIVENS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NMD, LEHP, SMN, OLO,
Mailing Address - Street 1:850 TWIN RIVERS DR UNIT 1930
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43216-8065
Mailing Address - Country:US
Mailing Address - Phone:330-222-3200
Mailing Address - Fax:326-888-7957
Practice Address - Street 1:519 5TH ST SW
Practice Address - Street 2:
Practice Address - City:MASSILLON
Practice Address - State:OH
Practice Address - Zip Code:44647-6519
Practice Address - Country:US
Practice Address - Phone:330-222-3200
Practice Address - Fax:326-888-7957
Is Sole Proprietor?:No
Enumeration Date:2021-12-23
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP1600X, 133N00000X, 171400000X, 175L00000X, 374J00000X, 175F00000X
ZZP202306080001207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No133N00000XDietary & Nutritional Service ProvidersNutritionist
No171400000XOther Service ProvidersHealth & Wellness Coach
No175L00000XOther Service ProvidersHomeopath
No374J00000XNursing Service Related ProvidersDoula
No175F00000XOther Service ProvidersNaturopath
Provider Identifiers
StateIdentifier IDID TypeIssuer
P202306080001OtherCOMPLEMENTARY MEDICAL ASSOCIATION MEMBERSHIP NUMBER