Provider Demographics
NPI:1023159845
Name:MEHTA, KIRIT N (MS, LPC, LMFT)
Entity type:Individual
Prefix:MR
First Name:KIRIT
Middle Name:N
Last Name:MEHTA
Suffix:
Gender:M
Credentials:MS, LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19927 FORT DAVIS CT
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77449-3305
Mailing Address - Country:US
Mailing Address - Phone:281-579-8942
Mailing Address - Fax:281-579-8942
Practice Address - Street 1:14740 BARRYKNOLL LN STE 130
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-2883
Practice Address - Country:US
Practice Address - Phone:713-984-5105
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2008-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11636101YP2500X
TX4295106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX027379904Medicaid
027379904OtherAMERIGROUP COMMUNITY CARE