Provider Demographics
NPI:1871685784
Name:MAHAJAN, USHA (LPCC)
Entity Type:Individual
Prefix:
First Name:USHA
Middle Name:
Last Name:MAHAJAN
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6300 N MAIN ST
Mailing Address - Street 2:SUITE 3
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45415-3154
Mailing Address - Country:US
Mailing Address - Phone:937-836-7666
Mailing Address - Fax:937-832-1168
Practice Address - Street 1:6300 N MAIN ST
Practice Address - Street 2:SUITE 3
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45415-3154
Practice Address - Country:US
Practice Address - Phone:937-836-7666
Practice Address - Fax:937-832-1168
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2009-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE-0003446101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
477817000OtherMAGELLAN HEALTH