Individual provider Active NPI

Abdirahman Farah

  • Behavior Technician
  • Saint Paul, MN
National Provider Identifier
1801614441
Registry record updated Oct 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
1410 Energy Park Dr Ste 11
Saint Paul, MN 55108-5249
Phone
(612) 452-5550
NPI assigned
Oct 2, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Primary

Addresses

Primary practice location

1410 Energy Park Dr Ste 11
Saint Paul, MN 55108-5249

Mailing address

1410 Energy Park Dr Ste 11
Saint Paul, MN 55108-5249
Phone (612) 452-5550

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

Practice roles

OrganizationSpecialtyStatusNew patients
Clearbridge ABA LLC Current Accepting new patients
Minnesota Therapy Center Inc CurrentSince Oct 6, 2024 Accepting new patients

Locations

1410 Energy Park Dr
Ste 11
Saint Paul, MN 55108
Phone (612) 452-5550

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1727827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727827200000",
    "number": "1801614441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1410 ENERGY PARK DR STE 11",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551085249",
            "telephone_number": "612-452-5550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 ENERGY PARK DR STE 11",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551085249",
            "telephone_number": "612-452-5550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARAH",
        "first_name": "ABDIRAHMAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-10-02",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 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.

Verify at the official NPI Registry.