Provider Demographics
NPI:1447828330
Name:SARDARYAN, GAYANE ARMIKI (LMSW)
Entity type:Individual
Prefix:
First Name:GAYANE
Middle Name:ARMIKI
Last Name:SARDARYAN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11040 72ND AVE APT 5B
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-4932
Mailing Address - Country:US
Mailing Address - Phone:917-514-8653
Mailing Address - Fax:
Practice Address - Street 1:6735 112TH ST
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-2349
Practice Address - Country:US
Practice Address - Phone:718-263-0740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-16
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY112382104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker