Active NPI
Amira Khalil, MPS, LADC
- Counselor
- Minneapolis, MN
National Provider Identifier
1689240442
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 3549
- Practice address
- 2118 Blaisdell Ave
Minneapolis, MN 55404-2415 - Phone
- (612) 235-4729
- Fax
- (612) 872-8855
- NPI assigned
- Jun 2, 2021
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 305812 | MN | |
| Counselor | 101Y00000X | 3549 | MN | Primary |
Addresses
Primary practice location
2118 Blaisdell Ave
Minneapolis, MN 55404-2415
Mailing address
2118 Blaisdell Ave
Minneapolis, MN 55404-2415
Phone (612) 235-4729
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
| License | State | Type | Specialty |
|---|---|---|---|
| 305812 | MN | MD | Addiction (Substance Use Disorder) Counselor |
| 3549 | MN | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1622592000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1708992000000",
"number": "1689240442",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2118 BLAISDELL AVE",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554042415",
"telephone_number": "612-235-4729"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2118 BLAISDELL AVE",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554042415",
"telephone_number": "612-235-4729",
"fax_number": "612-872-8855"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHALIL",
"first_name": "AMIRA",
"credential": "MPS, LADC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-06-02",
"last_updated": "2024-02-27",
"certification_date": "2024-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "MN",
"license": "305812",
"primary": false
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "MN",
"license": "3549",
"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 Feb 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.