Adams Autism Center

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

ADAMS AUTISM CENTER

Practice address

11070 Fergus St NE Unit B
Blaine, MN 55449-5072

Phone

(612) 401-3484

NPI assigned

May 31, 2022

Last updated

May 31, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ilyas Jama, OWNER

Title

Owner

Phone

(612) 401-3484

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1653955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653955200000",
    "number": "1013656982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11070 FERGUS ST NE UNIT B",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554495072",
            "telephone_number": "612-401-3484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11070 FERGUS ST NE UNIT B",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554495072",
            "telephone_number": "612-401-3484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADAMS AUTISM CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-31",
        "last_updated": "2022-05-31",
        "certification_date": "2022-05-31",
        "status": "A",
        "authorized_official_last_name": "JAMA",
        "authorized_official_first_name": "ILYAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-401-3484",
        "authorized_official_credential": "OWNER"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Blaine, MN
• Providers in Blaine, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 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.