Provider Demographics
NPI:1174688063
Name:KALHOR, MONA AMIN (PSY D)
Entity Type:Individual
Prefix:DR
First Name:MONA
Middle Name:AMIN
Last Name:KALHOR
Suffix:
Gender:F
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10101 GROSVENOR PL
Mailing Address - Street 2:APT 1606
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-4678
Mailing Address - Country:US
Mailing Address - Phone:954-732-1103
Mailing Address - Fax:954-476-7767
Practice Address - Street 1:11119 ROCKVILLE PIKE
Practice Address - Street 2:STE 316
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-3143
Practice Address - Country:US
Practice Address - Phone:301-230-8989
Practice Address - Fax:301-979-7007
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-22
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD05227103T00000X, 103TC2200X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL54880Medicare PIN