Provider Demographics
NPI:1720549389
Name:MEHDIKHAN, JOSHUA REZA (BH LPC)
Entity Type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:REZA
Last Name:MEHDIKHAN
Suffix:
Gender:M
Credentials:BH LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 N CENTRAL AVE STE 1050
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85004-1217
Mailing Address - Country:US
Mailing Address - Phone:602-266-8402
Mailing Address - Fax:
Practice Address - Street 1:3140 N ARIZONA AVE STE 113
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225-7167
Practice Address - Country:US
Practice Address - Phone:480-497-4040
Practice Address - Fax:480-497-4041
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-27
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-17939101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health