Provider Demographics
NPI:1669623344
Name:KHOSHAKHLAGH, SAHAR (PSYD, LMFT)
Entity type:Individual
Prefix:DR
First Name:SAHAR
Middle Name:
Last Name:KHOSHAKHLAGH
Suffix:
Gender:F
Credentials:PSYD, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 W 23RD ST STE 500
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-2599
Mailing Address - Country:US
Mailing Address - Phone:212-203-2758
Mailing Address - Fax:
Practice Address - Street 1:116 W 23RD ST STE 500
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-2599
Practice Address - Country:US
Practice Address - Phone:212-203-2758
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-01
Last Update Date:2020-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY133306195174400000X
NY000775-1106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No174400000XOther Service ProvidersSpecialist