Provider Demographics
NPI:1720506504
Name:PATEL, MEENAL (MA, LPC, QMHP, QIDP)
Entity type:Individual
Prefix:MS
First Name:MEENAL
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:MA, LPC, QMHP, QIDP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:390 17TH ST NW UNIT 3028
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30363-2006
Mailing Address - Country:US
Mailing Address - Phone:706-483-0634
Mailing Address - Fax:
Practice Address - Street 1:390 17TH ST NW UNIT 3028
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30363-2006
Practice Address - Country:US
Practice Address - Phone:706-483-0634
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-31
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC011597101YM0800X
IL178.012614101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health