Individual provider Active NPI

Sohrab R. Gandomi, PH.D.

  • Mental Health Counselor
  • Mesa, AZ
National Provider Identifier
1477566933
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LCC-0022 Issued in AZ
Practice address
1234 S Power Rd
Suite # 207
Mesa, AZ 85206-3700
Phone
(480) 731-9025
Fax
(480) 288-7327
NPI assigned
Aug 15, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LCC-0022 AZ Primary
Marriage & Family Therapist 106H00000X LMFT-0318 AZ

Addresses

Primary practice location

1234 S Power Rd
Suite # 207
Mesa, AZ 85206-3700

Mailing address

4651 S Louie Lamour Dr
Gold Canyon, AZ 85218-5816
Phone (480) 731-9025

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
LCC-0022AZMDMental Health Counselor
LMFT-0318AZMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1477566933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4651 S LOUIE LAMOUR DR",
            "city": "GOLD CANYON",
            "state": "AZ",
            "postal_code": "852185816",
            "telephone_number": "480-731-9025",
            "fax_number": "480-288-7327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1234 S POWER RD",
            "address_2": "SUITE # 207",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852063700",
            "telephone_number": "480-731-9025",
            "fax_number": "480-288-7327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANDOMI",
        "first_name": "SOHRAB",
        "middle_name": "R.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-15",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AZ",
            "license": "LCC-0022",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "AZ",
            "license": "LMFT-0318",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.