Provider Demographics
NPI:1770957508
Name:NIAZI, MEHR KHAN (LCSW)
Entity type:Individual
Prefix:
First Name:MEHR
Middle Name:KHAN
Last Name:NIAZI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8711 BUTTERFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23229-8125
Mailing Address - Country:US
Mailing Address - Phone:804-545-5929
Mailing Address - Fax:804-272-6355
Practice Address - Street 1:1601 ROLLING HILLS DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23229-5011
Practice Address - Country:US
Practice Address - Phone:804-545-5929
Practice Address - Fax:804-272-6355
Is Sole Proprietor?:No
Enumeration Date:2015-11-17
Last Update Date:2015-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040090301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical