Provider Demographics
NPI:1093106528
Name:MOHAMMADI, JAHLEH (MS, LMHC, NCC, CCPT)
Entity Type:Individual
Prefix:MS
First Name:JAHLEH
Middle Name:
Last Name:MOHAMMADI
Suffix:
Gender:F
Credentials:MS, LMHC, NCC, CCPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:635 JAMES ST STE 1
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13203-2661
Mailing Address - Country:US
Mailing Address - Phone:315-671-2964
Mailing Address - Fax:
Practice Address - Street 1:635 JAMES ST STE 1
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13203-2661
Practice Address - Country:US
Practice Address - Phone:315-671-2964
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-05
Last Update Date:2018-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006120101Y00000X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor