Healthcare Provider Details

I. General information

NPI: 1700648706
Provider Name (Legal Business Name): NIHA MAHBOOB LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2024
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 MONTICELLO ST STE 2
SOMERSET KY
42501-2974
US

IV. Provider business mailing address

599 WOODS EDGE DR
LONDON KY
40741-8145
US

V. Phone/Fax

Practice location:
  • Phone: 606-401-2966
  • Fax: 606-244-4111
Mailing address:
  • Phone: 859-699-1724
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number101YP2500X
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number290107
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: