Active NPI
Abdisallam Ahmed Abdulle
- School Counselor
- Minneapolis, MN
National Provider Identifier
1558875856
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Counselor
- License
- 494734
- Practice address
- 8609 Lyndale Ave S Ste 213C
Minneapolis, MN 55420-2769 - Phone
- (612) 200-9466
- NPI assigned
- Nov 22, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Counselor | 101YS0200X | 494734 | MN | Primary |
Addresses
Primary practice location
8609 Lyndale Ave S Ste 213C
Minneapolis, MN 55420-2769
Mailing address
8609 Lyndale Ave S Ste 213C
Minneapolis, MN 55420-2769
Phone (612) 200-9466
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 |
|---|---|---|---|
| 494734 | MN | MD | School Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Life Alliance, LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Early Intervention Provider Agency
- Bloomigton, MN
- NPI 1124542360
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1511308800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1511308800000",
"number": "1558875856",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8609 LYNDALE AVE S STE 213C",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554202769",
"telephone_number": "612-200-9466"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8609 LYNDALE AVE S STE 213C",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554202769",
"telephone_number": "612-200-9466"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ABDULLE",
"first_name": "ABDISALLAM",
"middle_name": "AHMED",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-11-22",
"last_updated": "2017-11-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YS0200X",
"taxonomy_group": "",
"desc": "Counselor, School",
"state": "MN",
"license": "494734",
"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 Nov 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.