Khalid Adam

Individual provider Active NPI Behavior Technician · Minneapolis, MN

NPI 1023689270 · NPPES record last updated Jul 8, 2021

Key facts

NPI
1023689270
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
2614 Nicollet Ave Ste 209
Minneapolis, MN 55408-1628
Phone
(612) 354-3995
NPI assigned
Jul 8, 2021
Sex
Male
Sole proprietor
No

Organizations & group practices 1

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.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Smart Therapy Center LLC Past
since Jul 17, 2021
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

2614 Nicollet Ave Ste 209
Minneapolis, MN 55408-1628

Mailing address

2614 Nicollet Ave Ste 209
Minneapolis, MN 55408-1628
Phone (612) 354-3995

Other providers in Minneapolis, MN

All providers in Minneapolis, MN · Behavior Technician in Minnesota

Sources for this page

Verify at the official NPI Registry.