Active NPI
Obsa Mohamed
- Mental Health Counselor
- Minneapolis, MN
National Provider Identifier
1194264549
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 929 Portland Ave Apt 2407
Minneapolis, MN 55404-1277 - Phone
- (612) 226-0907
- NPI assigned
- Feb 17, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Private Vehicle | 347C00000X | 902963300022 | MN | |
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
929 Portland Ave Apt 2407
Minneapolis, MN 55404-1277
Mailing address
2520 Rhode Island Ave N Apt 8
Golden Valley, MN 55427-3590
Phone (612) 226-0907
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 902963300022 | MN | MD | Private Vehicle |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Twin Cities Recovery Center LLC | Current | Accepting new patients | |
| Recovery Alliance LLC | Current | Accepting new patients |
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.
-
- Community/Behavioral Health Agency
- Minneapolis, MN
- NPI 1285258111
-
- Community/Behavioral Health Agency
- Eden Prairie, MN
- NPI 1376162941
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1487289600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635120000000",
"number": "1194264549",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2520 RHODE ISLAND AVE N APT 8",
"city": "GOLDEN VALLEY",
"state": "MN",
"postal_code": "554273590",
"telephone_number": "612-226-0907"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "929 PORTLAND AVE APT 2407",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554041277",
"telephone_number": "612-226-0907"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOHAMED",
"first_name": "OBSA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-02-17",
"last_updated": "2021-10-25",
"certification_date": "2021-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "347C00000X",
"taxonomy_group": "",
"desc": "Private Vehicle",
"state": "MN",
"license": "902963300022",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 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.