Provider Demographics
NPI:1881353654
Name:MEHTA, RAHUL (LPC, MS, NCC)
Entity type:Individual
Prefix:
First Name:RAHUL
Middle Name:
Last Name:MEHTA
Suffix:
Gender:M
Credentials:LPC, MS, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 CHALMERS ST
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63376-2417
Mailing Address - Country:US
Mailing Address - Phone:636-346-6788
Mailing Address - Fax:
Practice Address - Street 1:2705 SAINT PETERS HOWELL RD STE D
Practice Address - Street 2:
Practice Address - City:SAINT PETERS
Practice Address - State:MO
Practice Address - Zip Code:63376-2821
Practice Address - Country:US
Practice Address - Phone:636-346-6788
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-09
Last Update Date:2023-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2021047033101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO2021047033OtherMISSOURI DIVISION OF PROFESSIONAL REGISTRATION