Hamida Mahamed, LADC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

108539 Issued in MN

Practice address

5941 Washburn Ave S
Minneapolis, MN 55410-2848

Phone

(763) 587-5513

Fax

(612) 259-8084

NPI assigned

Apr 5, 2021

Sex

Female

Sole proprietor

Yes

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

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

{
    "created_epoch": "1617580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617580800000",
    "number": "1013596279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5941 WASHBURN AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554102848",
            "telephone_number": "612-709-3686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5941 WASHBURN AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554102848",
            "telephone_number": "763-587-5513",
            "fax_number": "612-259-8084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHAMED",
        "first_name": "HAMIDA",
        "credential": "LADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-05",
        "last_updated": "2021-04-05",
        "certification_date": "2021-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "MN",
            "license": "108539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Alla Orrick Magnuson, LICSW
• Amy Margarita Magras, RN
• Cathlin J Mahal, MSW, LICSW
• Stephanie Marie Mahal, OTR/L
• Deman Hodman Mahamed
• Sagal Mahamed
• Zahur Hassan Mahamed
• Ekrame Abdella Mahammed
• Mahamoud Mahamoud
• Abdallah Mahamud

• Substance Abuse Rehabilitation Facility in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Substance Abuse Rehabilitation Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2021; 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.