MEDICARE: DR. AARON B MEKHOUBAT PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	0701002361	VA
2	106H00000X	Marriage & Family Therapist	0717000051	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	158120000	OTHER	VA	MAGELLAN BEHAVIORAL HEALT
2	541834917	OTHER	VA	TRICARE
3	323687	OTHER	VA	ANTHEM BCBS
4	342367	OTHER	VA	MAMSI
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	2007414	OTHER	VA	CIGNA BEHAVIORAL HEALTH
7	336110	OTHER	VA	VALUE OPTION
8	7346205	OTHER	VA	AETNA HEALTH CARE
9	237206	OTHER	VA	ANTHEM BCBS HEALTHKEEPRS
10	087856	OTHER	VA	SENTARA
11	178550	OTHER	VA	COMPSYCH

General Provider Information

NPI Number	:	1538266192
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AARON B MEKHOUBAT PH.D.

Provider Business Mailing Address
First Line	:	PO BOX 2215
Second Line	:
City	:	CHESTERFIELD
State	:	VA
Zip	:	23832-9112
Country	:	US
Telephone Number	:	804-717-5419
Fax Number	:	804-520-8595

Provider Business Practice Location Address
First Line	:	10106 KRAUSE RD
Second Line	:
City	:	CHESTERFIELD
State	:	VA
Zip	:	23832-6572
Country	:	US
Telephone Number	:	804-717-5419
Fax Number	:	804-520-8595

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/17/2006
Last Update Date	:	07/18/2008

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