Healthcare Provider Details

I. General information

NPI: 1285142513
Provider Name (Legal Business Name): SHEENA MEHTA PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/22/2018
Last Update Date: 07/09/2025
Certification Date: 07/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3035 NW 63RD ST STE 227
OKLAHOMA CITY OK
73116-3631
US

IV. Provider business mailing address

3035 NW 63RD ST STE 227
OKLAHOMA CITY OK
73116-3631
US

V. Phone/Fax

Practice location:
  • Phone: 405-242-6460
  • Fax: 405-544-5916
Mailing address:
  • Phone: 405-242-6460
  • Fax: 405-544-5916

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number289365
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number1302
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: