Abdikassim Abdikadir Ahmed
Individual provider Active NPI Behavior Technician · Saint Paul, MN
NPI 1669359352 · NPPES record last updated Aug 16, 2025
Key facts
- NPI
- 1669359352
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 2147 University Ave W Ste 108
Saint Paul, MN 55114-1326 - Phone
- (617) 992-1536
- Fax
- (612) 778-8718
- NPI assigned
- Aug 16, 2025
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| South Lake Autism Center L. L. C. | Current |
Accepting new patients |
Locations
2147 University Ave W
Ste 108
Saint Paul, MN 55114
Phone (617) 992-1536
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Yes |
Addresses
Primary practice location
2147 University Ave W Ste 108
Saint Paul, MN 55114-1326
Mailing address
2147 University Ave W Ste 108
Saint Paul, MN 55114-1326
Phone (617) 992-1536
Other providers in Saint Paul, MN
- Abdulqadir Ahmed Khalif
- Zayed I Ahmed Lamu
- Ahmed Salad Associates
- Abdalla Ahmed
- Abdifatah Ahmed
- Abdirizak Ahmed
- Aisho Ahmed
- Amin Abdi Ahmed
- Amina Abdirahman Ahmed
- Amira Ahmed
All providers in Saint Paul, MN · Behavior Technician in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 16, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.