Individual provider Active NPI

Mohamoud Abdi Hussein

  • Mental Health Counselor
  • Minneapolis, MN
National Provider Identifier
1629599642
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
23184 Issued in MN
Practice address
1011 W Broadway Ave
Suite 218
Minneapolis, MN 55411
Phone
(612) 236-4179
NPI assigned
Jun 29, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 23184 MN Primary

Addresses

Primary practice location

1011 W Broadway Ave
Suite 218
Minneapolis, MN 55411

Mailing address

1011 W Broadway Ave Ste 218
Minneapolis, MN 55411-2531
Phone (612) 236-4179

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

LicenseStateTypeSpecialty
23184MNMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Sunrise Home Health Care, Inc PastSince Jul 24, 2022 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.

NPI Registry JSON

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

{
    "created_epoch": "1498694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1629599642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 W BROADWAY AVE STE 218",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554112531",
            "telephone_number": "612-236-4179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 W BROADWAY AVE",
            "address_2": "SUITE 218",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55411",
            "telephone_number": "612-236-4179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUSSEIN",
        "first_name": "MOHAMOUD",
        "middle_name": "ABDI",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-06-29",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "23184",
            "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 Jul 21, 2022; 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.