Healthcare Provider Details

I. General information

NPI: 1114630464
Provider Name (Legal Business Name): AASHA MENTAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2023
Last Update Date: 01/03/2023
Certification Date: 01/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4905 OLD ORCHARD CTR STE 521
SKOKIE IL
60077-4736
US

IV. Provider business mailing address

3015 KEYSTONE RD
NORTHBROOK IL
60062-5107
US

V. Phone/Fax

Practice location:
  • Phone: 312-545-6435
  • Fax:
Mailing address:
  • Phone: 312-545-6435
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: NEHA R PATEL
Title or Position: LICENSED CLINICAL PSYCHOLOGIST
Credential: PSY.D.
Phone: 312-545-6435