Organization Active NPI

First Choice Autism Services Inc

  • Clinical Child & Adolescent Psychologist
  • Minneapolis, MN
National Provider Identifier
1609564822
Registry record updated May 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
Legal business name
FIRST CHOICE AUTISM SERVICES INC
Practice address
1913 Broadway St NE
Minneapolis, MN 55413-2627
Phone
(952) 657-9064
NPI assigned
Apr 26, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 10, 2023

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

Authorized official

Name
Khadra Mohamud
Title
Owner
Phone
(952) 657-9064

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC2200X Primary

Addresses

Primary practice location

1913 Broadway St NE
Minneapolis, MN 55413-2627

Mailing address

1913 Broadway St NE
Minneapolis, MN 55413-2627
Phone (952) 657-9064

National Provider Directory

National Provider Directory

Locations

1913 Broadway St NE
Minneapolis, MN 55413
Phone (952) 657-9064

NPI Registry JSON

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

{
    "created_epoch": "1682467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683676800000",
    "number": "1609564822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1913 BROADWAY ST NE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554132627",
            "telephone_number": "952-657-9064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1913 BROADWAY ST NE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554132627",
            "telephone_number": "952-657-9064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST CHOICE AUTISM SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-26",
        "last_updated": "2023-05-10",
        "certification_date": "2023-04-26",
        "status": "A",
        "authorized_official_last_name": "MOHAMUD",
        "authorized_official_first_name": "KHADRA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "952-657-9064"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "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 May 10, 2023; 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.