Provider Demographics
NPI:1740163062
Name:JAHANKHAH, AYSAN (MHC-LP)
Entity type:Individual
Prefix:
First Name:AYSAN
Middle Name:
Last Name:JAHANKHAH
Suffix:
Gender:F
Credentials:MHC-LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 ONCREST TER
Mailing Address - Street 2:
Mailing Address - City:CLIFFSIDE PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07010-2814
Mailing Address - Country:US
Mailing Address - Phone:551-251-8881
Mailing Address - Fax:
Practice Address - Street 1:330 W 58TH ST STE 305
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-1801
Practice Address - Country:US
Practice Address - Phone:347-292-1216
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-26
Last Update Date:2025-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP135551101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health