Rasoul Mokhtari, M.S. BCBA

Primary specialty

Developmental TherapistTaxonomy code 222Q00000X

Practice address

4636 Lebanon Pike # 167
Hermitage, TN 37076-1316

Phone

(615) 476-0401

Fax

(615) 777-3210

NPI assigned

Oct 5, 2009

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Creative Minds Behavior Services, LLC

  • Behavior Analyst
  • Hermitage, TN
  • NPI 1831574565
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1254700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1093040347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4636 LEBANON PIKE # 167",
            "city": "HERMITAGE",
            "state": "TN",
            "postal_code": "370761316",
            "telephone_number": "615-476-0401",
            "fax_number": "615-777-3210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4636 LEBANON PIKE # 167",
            "city": "HERMITAGE",
            "state": "TN",
            "postal_code": "370761316",
            "telephone_number": "615-476-0401",
            "fax_number": "615-777-3210"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1004 Hickory Hill Ln Ste 4",
            "address_purpose": "LOCATION",
            "city": "Hermitage",
            "state": "TN",
            "postal_code": "370761931",
            "country_code": "US",
            "telephone_number": "615-902-0950",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOKHTARI",
        "first_name": "RASOUL",
        "credential": "M.S. BCBA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-05",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura L Miller
• Taylor Rose Miller
• Matthew H Milligan, MD
• Mitzie Michelle Slayden
• Amira A Mohamad
• Christopher A Molini, M.D.
• Deborah G Montgomery, M.D.
• Teasha Moody
• Kayla Moore
• Lydia Morefield-Parrish, RN

• Developmental Therapist in Hermitage, TN
• Providers in Hermitage, TN by specialty
• Developmental Therapist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.