Fadumo Adan

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

3333 W Division St Ste 116
Saint Cloud, MN 56301-4548

Phone

(612) 806-9954

Fax

(320) 669-2882

NPI assigned

Feb 2, 2021

Sex

Female

Sole proprietor

No

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

Practice roles

Locations

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.

• Star Autism Center

  • Adolescent and Children Mental Health Clinic/Center
  • Saint Cloud, MN
  • NPI 1801409099
  NPD

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

{
    "created_epoch": "1612224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612224000000",
    "number": "1275124174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 W DIVISION ST STE 116",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563014548",
            "telephone_number": "612-806-9954",
            "fax_number": "320-669-2882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 W DIVISION ST STE 116",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563014548",
            "telephone_number": "612-806-9954",
            "fax_number": "320-669-2882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADAN",
        "first_name": "FADUMO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-02",
        "last_updated": "2021-02-02",
        "certification_date": "2021-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Elaine Ackerman, CMT
• Acquire Health Center LLC
• Angela Adamek, CNP
• Carolyn Adams
• Kelly Adams, RBT
• Hafso Ahmed Adan
• Ilhan Adan
• Najah Yusuf Adan
• Sumaya Ahmed Adan
• Adaptive Home Solutions

• Behavior Technician in Saint Cloud, MN
• Providers in Saint Cloud, MN by specialty
• Behavior Technician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 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.