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

LicenseStateTypeSpecialty
155250AZMDAddiction (Substance Use Disorder) Counselor

Interoperability endpoints

  • Direct secure messaging: gibran.ameer.p1@direct.terros.nextgenshare.com

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
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

Other providers in Glendale, AZ

All providers in Glendale, AZ · Addiction (Substance Use Disorder) Counselor in Arizona

Sources for this page

Verify at the official NPI Registry.