Provider Demographics
NPI:1508178021
Name:MEHTA, KAYNAZ (LMHC)
Entity Type:Individual
Prefix:
First Name:KAYNAZ
Middle Name:
Last Name:MEHTA
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 WOBURN ST
Mailing Address - Street 2:SUITE 6
Mailing Address - City:READING
Mailing Address - State:MA
Mailing Address - Zip Code:01867-2973
Mailing Address - Country:US
Mailing Address - Phone:617-297-7150
Mailing Address - Fax:
Practice Address - Street 1:36 WOBURN ST
Practice Address - Street 2:SUITE 6
Practice Address - City:READING
Practice Address - State:MA
Practice Address - Zip Code:01867-2973
Practice Address - Country:US
Practice Address - Phone:617-297-7150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-13
Last Update Date:2016-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7463101YA0400X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)