Mariam Muhiddin Ibrahim

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

205 14TH Ave E
Sartell, MN 56377-4500

Phone

(320) 774-3436

Fax

(320) 774-3440

NPI assigned

Mar 22, 2022

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Northway Academy, Inc.

  • Developmental Disabilities Clinic/Center
  • Saint Cloud, MN
  • NPI 1104333715
  NPD (past)

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

{
    "created_epoch": "1647907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762041600000",
    "number": "1609525013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 W RUSSELL ST",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571041322",
            "telephone_number": "605-271-2690",
            "fax_number": "605-271-3956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 14TH AVE E",
            "city": "SARTELL",
            "state": "MN",
            "postal_code": "563774500",
            "telephone_number": "320-774-3436",
            "fax_number": "320-774-3440"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3721 23rd St S Ste 201",
            "address_purpose": "LOCATION",
            "city": "Saint Cloud",
            "state": "MN",
            "postal_code": "563016199",
            "country_code": "US",
            "telephone_number": "605-271-2690",
            "fax_number": "605-271-3956",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IBRAHIM",
        "first_name": "MARIAM",
        "middle_name": "MUHIDDIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-22",
        "last_updated": "2025-11-02",
        "certification_date": "2025-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "373H00000X",
            "taxonomy_group": "",
            "desc": "Day Training/Habilitation Specialist",
            "state": "MN",
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Calvin Reed Hundeby
• Christine Hupe, FNP-C
• Abukar Abdullahi Hussein
• Matthew Ronald Hwang, M.D.
• I-Implant Dentistry
• Nawal Aden Ibrahim
• Ubah Afi Ibrahim
• Shamso Iman
• Independent Living Services of Central Minnesota
• Integracare LTD

• Behavior Technician in Sartell, MN
• Providers in Sartell, MN by specialty
• Behavior Technician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2025; 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.