Dr Mohammad Mehdi Momtahan, PHD - Counselor in Dallas, GA

Dr Mohammad Mehdi Momtahan, PHD is a Counselor - Professional based in Dallas, Georgia. Dr Mohammad Mehdi Momtahan is licensed to practice in Georgia (license number LPC004345) and his current practice location is 59 Hillside Trace, Suite 113, Dallas, Georgia. He can be reached at his office (for appointments etc.) via phone at (770) 443-1644.

NPI number for Dr Mohammad Mehdi Momtahan is 1225271422 and his current mailing address is 59 Hillside Trce, Suite 113, Dallas, Georgia. He does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1225271422.

Contact Information

Dr Mohammad Mehdi Momtahan, PHD
59 Hillside Trace, Suite 113,
Dallas, GA 30157-3315
(770) 443-1644
(770) 443-1633

Map and Direction


Healthcare Provider's Profile

Full NameDr Mohammad Mehdi Momtahan
GenderMale
SpecialityCounselor - Professional
Location59 Hillside Trace, Dallas, Georgia
Accepts Medicare AssignmentsDoes not participate in Medicare Program. He may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1225271422
  • Provider Enumeration Date: 04/17/2009
  • Last Update Date: 01/05/2015

Medical Identifiers

Medical identifiers for Dr Mohammad Mehdi Momtahan such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1225271422NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
101Y00000XCounselor NCC 210724 (Georgia)Secondary
101YA0400XCounselor - Addiction (substance Use Disorder) C0040 (Georgia)Secondary
101YA0400XCounselor - Addiction (substance Use Disorder) MAC 12619 (Indiana)Secondary
101YA0400XCounselor - Addiction (substance Use Disorder) ICAADC 202225 (Georgia)Secondary
101YA0400XCounselor - Addiction (substance Use Disorder) CCODP-D 0004 (Georgia)Secondary
101YM0800XCounselor - Mental Health ACS 00557 (Georgia)Secondary
101YP2500XCounselor - Professional LPC004345 (Georgia)Primary
174400000XSpecialist CFAS 12619 (Indiana)Secondary
174400000XSpecialist BDFC 12619 (Indiana)Secondary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Mohammad Mehdi Momtahan is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dr Mohammad Mehdi Momtahan, PHD
59 Hillside Trce, Suite 113,
Dallas, GA 30157-9476

Ph: (770) 443-1644
Dr Mohammad Mehdi Momtahan, PHD
59 Hillside Trace, Suite 113,
Dallas, GA 30157-3315

Ph: (770) 443-1644

Reviews and Comments


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