Provider Demographics
NPI:1972607919
Name:MEHL, ROCHELLE C (PHD)
Entity type:Individual
Prefix:DR
First Name:ROCHELLE
Middle Name:C
Last Name:MEHL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11730 OLD SHELBYVILLE RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40243-1482
Mailing Address - Country:US
Mailing Address - Phone:502-883-4073
Mailing Address - Fax:502-883-4139
Practice Address - Street 1:11730 OLD SHELBYVILLE RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40243-1482
Practice Address - Country:US
Practice Address - Phone:502-883-4073
Practice Address - Fax:502-883-4139
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-11
Last Update Date:2015-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY1274103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000360711OtherANTHEM BLUE CROSS BLUE SHIELD
KY000000360711OtherANTHEM BLUE CROSS BLUE SHIELD
KYP38921Medicare UPIN