Healthcare Provider Details

I. General information

NPI: 1639036866
Provider Name (Legal Business Name): AISHA KHORANA M.ED., PLPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

967 GARDENVIEW OFFICE PKWY
CREVE COEUR MO
63141-5917
US

IV. Provider business mailing address

967 GARDENVIEW OFFICE PKWY
CREVE COEUR MO
63141-5917
US

V. Phone/Fax

Practice location:
  • Phone: 314-561-9757
  • Fax:
Mailing address:
  • Phone: 314-561-9757
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2025043505
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: