MOHAMMAD MEHDI MOMTAHAN
Counselor

Address: 59 Hillside Trace, Suite 113, Dallas, GA 30157-3315

MOHAMMAD MEHDI MOMTAHAN (NPI# 1225271422) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1225271422
Entity Type Individual
Full Name DR. MOHAMMAD MEHDI MOMTAHAN
Gender Male
Credential PH.D.
Practice Address 59 Hillside Trace
Suite 113
Dallas
GA 30157-3315
Practice Telephone 7704431644
Practice Fax Number 7704431633
Mailing Address 59 Hillside Trce
Suite 113
Dallas
GA 30157-9476
Mailing Telephone 7704431644
Mailing Fax Number 7704431633
Enumeration Date 2009-04-17
Last Update Date 2015-01-05
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification Taxonomy Group License Number License State Grouping
N 101Y00000X Counselor NCC 210724 GA Behavioral Health & Social Service Providers
N 101YA0400X Counselor
Specialization: Addiction (Substance Use Disorder)
CCODP-D 0004 GA Behavioral Health & Social Service Providers
N 101YA0400X Counselor
Specialization: Addiction (Substance Use Disorder)
ICAADC 202225 GA Behavioral Health & Social Service Providers
N 101YA0400X Counselor
Specialization: Addiction (Substance Use Disorder)
MAC 12619 IN Behavioral Health & Social Service Providers
N 101YA0400X Counselor
Specialization: Addiction (Substance Use Disorder)
C0040 GA Behavioral Health & Social Service Providers
N 101YM0800X Counselor
Specialization: Mental Health
ACS 00557 GA Behavioral Health & Social Service Providers
Y 101YP2500X Counselor
Specialization: Professional
LPC004345 GA Behavioral Health & Social Service Providers
N 174400000X Specialist BDFC 12619 IN Other Service Providers
N 174400000X Specialist CFAS 12619 IN Other Service Providers

Office Location

Street Address 59 HILLSIDE TRACE
SUITE 113
City DALLAS
State GA
Zip Code 30157-3315

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1831185867 Roger W Scott Jr. Optometrist 4075 Marietta Hwy, 110, Dallas, GA 30157-3315 2005-09-26

Providers in the same zip code prefix

NPI Name Taxonomy Address Enumeration
1659864593 Sierra Renee Barr · Sierra Renee Anderson Nurse Practitioner - Family 495 Charles Hardy Pkwy, Dallas, GA 30157 2018-06-13
1003211079 Melissa Brice Lactation Consultant, Non-RN 430 Parson Rd, Dallas, GA 30157 2014-11-03
1922608629 Harshadbhai Vinubhai Patel Pharmacist 3615 Marietta Highway, Dallas, GA 30157 2020-10-30
1790017705 Kristi L Baggett Speech-Language Pathologist 3044 Due West Rd, Dallas, GA 30157 2010-02-02
1154340529 Laura Schell Physical Therapist 110 Evans Mill Dr Ste 206, Dallas, GA 30157 2006-07-18
1619459062 Emily Nicole Koopman Specialist/Technologist - Athletic Trainer 399 Powder Creek Way, Dallas, GA 30157 2018-09-02
1114103686 Christine J. Mezza Counselor - Professional 2260 Gold Mine Rd, Dallas, GA 30157 2008-01-15
1104101690 Jared Alan Lott Pharmacist 303 Charlie Watts Blvd, Dallas, GA 30157 2011-10-15
1043852627 Lindsay Sheets Dentist 59 Hillside Trce Ste 105, Dallas, GA 30157 2019-10-15
1689950032 Okwuchi Obialor Pharmacist 303 Charlie Watts Blvd, Dallas, GA 30157 2011-10-31
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Taxonomy Information

Taxonomy Code 101Y00000X
Grouping Behavioral Health & Social Service Providers
Classification Counselor

Taxonomy Definition

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification.
Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1710553755 Chase Olivia Sorrells Counselor 8035 Erl Thornton Fwy, 251, Dallas, TX 75228 2021-06-01
1568038628 Delicia Julien Counselor 104 Gardenia Ln, Dallas, GA 30132-4493 2021-05-31
1043885627 Jasmine Gonzalez Counselor 16610 Dallas Pkwy Ste 2100, Dallas, TX 75248-2690 2021-05-25
1184299190 Julie Dyer Counselor 4240 Sigma Rd, Dallas, TX 75244-4414 2021-05-21
1225602451 Diamond Diagnostic Center Counselor 9535 Forest Ln Ste 290, Dallas, TX 75243-5900 2021-05-13
1437740461 Kierra Genae Taylor Counselor 18788 Marsh Ln Apt 1520, Dallas, TX 75287-3549 2021-02-02
1245836121 Reginald Smith Counselor 1513 N Haskell Ave # 102, Dallas, TX 75204-5220 2020-12-07
1013512409 Elizabeth Ball Counselor 1400 N Westmoreland Rd, Dallas, TX 75211-1656 2020-12-02
1003416389 Megan Marie Daniel Counselor 11040 Mccree Rd, Dallas, TX 75238-3033 2020-10-27
1124627682 Preston Ivey Counselor 6001 Summerside Dr Ste 202, Dallas, TX 75252-5336 2020-10-25
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Competitor

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City DALLAS
Zip Code 30157

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.