NPIMap

Organization Active NPI

Integrated Counseling Health Services Inc

  • Clinic/Center
  • Fridley, MN
National Provider Identifier
1629789565
Registry record updated Dec 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
INTEGRATED COUNSELING HEALTH SERVICES INC
Practice address
1250 Moore Lake Dr E Ste 212
Fridley, MN 55432-5136
Phone
(612) 479-2085
NPI assigned
Dec 12, 2022
Last updated
Dec 12, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2022

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

Authorized official

Name
Ayanle AbdihooshNPI 1114788528
Title
Co-Owner
Phone
(612) 479-2085

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU Primary

Addresses

Primary practice location

1250 Moore Lake Dr E Ste 212
Fridley, MN 55432-5136

Mailing address

1250 Moore Lake Dr E Ste 212
Fridley, MN 55432-5136

National Provider Directory

National Provider Directory

Locations

1250 Moore Lake Dr E
Ste 212
Fridley, MN 55432
Phone (612) 479-2085

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1670803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670803200000",
    "number": "1629789565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 MOORE LAKE DR E STE 212",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554325136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 MOORE LAKE DR E STE 212",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554325136",
            "telephone_number": "612-479-2085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED COUNSELING HEALTH SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-12",
        "last_updated": "2022-12-12",
        "certification_date": "2022-12-12",
        "status": "A",
        "authorized_official_last_name": "ABDIHOOSH",
        "authorized_official_first_name": "AYANLE",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "612-479-2085"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fridley, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 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.