Active NPI
Manal Yussuf Ahmed
- Behavior Technician
- St Anthony, MN
National Provider Identifier
1679286967
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 3055 Old Highway 8 Ste 190
Saint Anthony, MN 55418-2595 - Phone
- (612) 267-6293
- NPI assigned
- Jan 2, 2023
- Last updated
- Jan 2, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adolescent and Children Mental Health Clinic/Center | 261QM0855X | NU | ||
| Behavior Technician | 106S00000X | NU | Primary |
Addresses
Primary practice location
3055 Old Highway 8 Ste 190
Saint Anthony, MN 55418-2595
Mailing address
333 Rice Creek Ter NE
Fridley, MN 55432-4437
Phone (763) 843-0755
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1672617600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1672617600000",
"number": "1679286967",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "333 RICE CREEK TER NE",
"city": "FRIDLEY",
"state": "MN",
"postal_code": "554324437",
"telephone_number": "763-843-0755"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3055 OLD HIGHWAY 8 STE 190",
"city": "SAINT ANTHONY",
"state": "MN",
"postal_code": "554182595",
"telephone_number": "612-267-6293"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AHMED",
"first_name": "MANAL",
"middle_name": "YUSSUF",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-01-02",
"last_updated": "2023-01-02",
"certification_date": "2023-01-02",
"status": "A"
},
"taxonomies": [
{
"code": "261QM0855X",
"taxonomy_group": "",
"desc": "Clinic/Center, Adolescent and Children Mental Health",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in St Anthony, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 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.