Active NPI
Raha Mohamoud
- Behavior Technician
- Minneapolis, MN
National Provider Identifier
1487323408
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 4001 Stinson Blvd Ste 314
Minneapolis, MN 55421-3424 - Phone
- (612) 208-0729
- Fax
- (612) 354-3801
- NPI assigned
- Sep 13, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | MN | Primary |
Addresses
Primary practice location
4001 Stinson Blvd Ste 314
Minneapolis, MN 55421-3424
Mailing address
3309 E 125TH St
Burnsville, MN 55337-3445
Phone (612) 946-4671
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1631491200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1631491200000",
"number": "1487323408",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3309 E 125TH ST",
"city": "BURNSVILLE",
"state": "MN",
"postal_code": "553373445",
"telephone_number": "612-946-4671"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4001 STINSON BLVD STE 314",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554213424",
"telephone_number": "612-208-0729",
"fax_number": "612-354-3801"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOHAMOUD",
"first_name": "RAHA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-09-13",
"last_updated": "2021-09-13",
"certification_date": "2021-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "MN",
"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 Sep 13, 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.