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General NPI Number Information
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NPI Number | 1689485641
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Entity Type | Organization
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Legal Business Name | MENDA BEHAVIORAL HEALTH SERVICES PC
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Dates
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Enumeration Date | 01/17/2025
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Last Update Date | 01/17/2025
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Provider Practice Location Address
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Address Line | 115 N CALHOUN ST STE 4
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City | TALLAHASSEE
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State | FL
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Zip | 32301-1568
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Country | US
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Telephone | 323-776-3632
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Fax |
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Provider Business Mailing Address
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Address Line | 1303 PENDLETON ST SE
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City | ATLANTA
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State | GA
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Zip | 30316-3801
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | FOUNDER
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Name | KARTIKEYA SHASTRI
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Credential |
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Telephone | 323-776-3632
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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