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Individual
MR. MEHRYAR TABIB
Active
Individual
MR. MEHRYAR TABIB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW-C
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
07578
MD
1041C0700X
Clinical Social Worker
Primary
07578
MD
1041C0700X
Clinical Social Worker
992792
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
259147-000
MAGELLAN BEHAVIORAL HEALTH
MD
01
—
346646
MHN
MD
01
—
517251
OPTUM / UBH
MD
05
—
609550001
—
MD
01
—
7840093
AETNA
MD
01
—
R968
CAREFIRST
MD
Enumeration date
06/09/2006
Last updated
01/12/2016
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