Provider Demographics
NPI:1952855314
Name:PATEL-SHAH, PRIYA (MS, PHD)
Entity Type:Individual
Prefix:MS
First Name:PRIYA
Middle Name:
Last Name:PATEL-SHAH
Suffix:
Gender:F
Credentials:MS, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2714 MEYER PL
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19114-3497
Mailing Address - Country:US
Mailing Address - Phone:918-549-0366
Mailing Address - Fax:
Practice Address - Street 1:702 JAMES AVE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37209-1292
Practice Address - Country:US
Practice Address - Phone:918-549-0366
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-15
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKLPC06831101YM0800X
251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No251S00000XAgenciesCommunity/Behavioral Health