Provider Demographics
NPI:1295299303
Name:KHALIF, MOHAMED O (PHD, LPC)
Entity type:Individual
Prefix:
First Name:MOHAMED
Middle Name:O
Last Name:KHALIF
Suffix:
Gender:M
Credentials:PHD, LPC
Other - Prefix:
Other - First Name:MOHAMED
Other - Middle Name:
Other - Last Name:KHALIF
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD, LPC
Mailing Address - Street 1:9304 FOREST LN STE S143
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-6238
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9304 FOREST LN STE S143
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-6238
Practice Address - Country:US
Practice Address - Phone:469-990-6958
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-23
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX89211101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional