Provider Demographics
NPI:1538266192
Name:MEKHOUBAT, AARON B (PHD)
Entity type:Individual
Prefix:DR
First Name:AARON
Middle Name:B
Last Name:MEKHOUBAT
Suffix:
Gender:M
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:PO BOX 2215
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23832-9112
Mailing Address - Country:US
Mailing Address - Phone:804-717-5419
Mailing Address - Fax:804-520-8595
Practice Address - Street 1:10106 KRAUSE RD
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23832-6572
Practice Address - Country:US
Practice Address - Phone:804-717-5419
Practice Address - Fax:804-520-8595
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-17
Last Update Date:2008-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701002361101YP2500X
VA0717000051106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA158120000OtherMAGELLAN BEHAVIORAL HEALT
VA541834917OtherTRICARE
VA323687OtherANTHEM BCBS
VA342367OtherMAMSI
VA005400040Medicaid
VA2007414OtherCIGNA BEHAVIORAL HEALTH
VA336110OtherVALUE OPTION
VA7346205OtherAETNA HEALTH CARE
VA237206OtherANTHEM BCBS HEALTHKEEPRS
VA087856OtherSENTARA
VA178550OtherCOMPSYCH