Hasan A Abdushahid

Individual provider Active NPI Community/Behavioral Health Agency · Charlotte, NC

NPI 1093584658 · NPPES record last updated May 6, 2025

Key facts

NPI
1093584658
Entity type
Individual (NPI type 1)
Primary specialty
Community/Behavioral Health Agency 251S00000X
Practice address
1914 J N Pease PL
Charlotte, NC 28262-4504
Phone
(980) 229-8303
NPI assigned
Dec 25, 2023
Sex
Male
Sole proprietor
Yes

Organizations & group practices 2

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
Natural Support Services Mental Health Current
since May 11, 2025
Accepting new patients
Boondock Express Mental Health Current
since Dec 31, 2023
Accepting new patients

Locations

1914 J N Pease Pl
Charlotte, NC 28262
Phone (704) 754-8718

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X
Developmentally Disabled Services Day Training Agency 251C00000X
Chore Provider 372500000X
Mental Health Counselor 101YM0800X
Behavior Technician 106S00000X
Adult Companion 372600000X
Day Training/Habilitation Specialist 373H00000X
Personal Care Attendant 3747P1801X
Nurse's Aide 376K00000X
Community/Behavioral Health Agency 251S00000X Yes
Home Health Aide 374U00000X
Homemaker 376J00000X

Addresses

Primary practice location

1914 J N Pease PL
Charlotte, NC 28262-4504

Mailing address

10216 Chatham Run LN
Charlotte, NC 28262-3075
Phone (980) 229-8303

Other practice location 1

10216 Chatham Run Ln
Charlotte, NC 28262-3075
Phone (980) 229-8303

Other providers in Charlotte, NC

All providers in Charlotte, NC · Community/Behavioral Health Agency in North Carolina

Sources for this page

Verify at the official NPI Registry.