Active NPI
Fartun Ahmed, LADC
- Addiction (Substance Use Disorder) Counselor
- Minnetonka, MN
National Provider Identifier
1801397302
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 305005
- Practice address
- 16020 Temple Dr
Minnetonka, MN 55345-3422 - Phone
- (612) 845-9692
- Fax
- (952) 223-6155
- NPI assigned
- Feb 21, 2018
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 305005 | MN | Primary |
Addresses
Primary practice location
16020 Temple Dr
Minnetonka, MN 55345-3422
Mailing address
715 9TH Ave S
Hopkins, MN 55343-7708
Phone (612) 481-8502
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 305005 | Other | MN | STATE OF MINNESTOA |
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 |
|---|---|---|---|
| 305005 | MN | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1519171200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1519171200000",
"number": "1801397302",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "715 9TH AVE S",
"city": "HOPKINS",
"state": "MN",
"postal_code": "553437708",
"telephone_number": "612-481-8502"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16020 TEMPLE DR",
"city": "MINNETONKA",
"state": "MN",
"postal_code": "553453422",
"telephone_number": "612-845-9692",
"fax_number": "952-223-6155"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AHMED",
"first_name": "FARTUN",
"credential": "LADC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-02-21",
"last_updated": "2018-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "MN",
"license": "305005",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE OF MINNESTOA",
"identifier": "305005",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Minnetonka, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.