Gibran A Ameer, LISAC
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Glendale, AZ
NPI 1700527736 · NPPES record last updated Apr 5, 2022
Key facts
- NPI
- 1700527736
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- 155250 (AZ)
- Practice address
- 6151-6153 W Olive Ave
Glendale, AZ 85302-4598 - Phone
- (602) 685-6000
- Fax
- (602) 389-3599
- NPI assigned
- Apr 5, 2022
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 155250 | AZ | MD | Addiction (Substance Use Disorder) Counselor |
Interoperability endpoints
- gibran.ameer.p1@direct.terros.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 155250 | AZ | Yes |
Addresses
Primary practice location
6151-6153 W Olive Ave
Glendale, AZ 85302-4598
Mailing address
3003 N Central Ave Ste 400
Phoenix, AZ 85012-2929
Phone (602) 685-6000
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 5, 2022. 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.