=====================================================
General NPI Number Information
=====================================================
NPI Number | 1285142513
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SHEENA MEHTA PHD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/22/2018
-----------------------------------------------------
Last Update Date | 07/09/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3035 NW 63RD ST STE 227
-----------------------------------------------------
City | OKLAHOMA CITY
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 73116-3631
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 405-242-6460
-----------------------------------------------------
Fax | 405-544-5916
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3035 NW 63RD ST STE 227
-----------------------------------------------------
City | OKLAHOMA CITY
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 73116-3631
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 405-242-6460
-----------------------------------------------------
Fax | 405-544-5916
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103T00000X
-----------------------------------------------------
Taxonomy Name | Psychologist
-----------------------------------------------------
License Number | 289365
-----------------------------------------------------
License Number State | KY
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 103TH0100X
-----------------------------------------------------
Taxonomy Name | Health Service Psychologist
-----------------------------------------------------
License Number | 1302
-----------------------------------------------------
License Number State | OK
-----------------------------------------------------