Active NPI
Fardowsa Ahmed Hassan, LADC
- Addiction (Substance Use Disorder) Counselor
- Saint Paul, MN
National Provider Identifier
1497322267
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 305947
- Practice address
- 1246 University Ave W
Saint Paul, MN 55104-4125 - Phone
- (651) 204-7009
- NPI assigned
- Jun 9, 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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 305947 | MN | Primary |
Addresses
Primary practice location
1246 University Ave W
Saint Paul, MN 55104-4125
Mailing address
5951 University Ave NE Apt 421
Fridley, MN 55432-2886
Phone (612) 242-4098
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 |
|---|---|---|---|
| 305947 | MN | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1623196800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623196800000",
"number": "1497322267",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5951 UNIVERSITY AVE NE APT 421",
"city": "FRIDLEY",
"state": "MN",
"postal_code": "554322886",
"telephone_number": "612-242-4098"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1246 UNIVERSITY AVE W",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551044125",
"telephone_number": "651-204-7009"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HASSAN",
"first_name": "FARDOWSA",
"middle_name": "AHMED",
"credential": "LADC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-06-09",
"last_updated": "2021-06-09",
"certification_date": "2021-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "MN",
"license": "305947",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 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.