Shamsa Ahmed Ali

Individual provider Active NPI Behavior Technician · Sartell, MN

NPI 1821828633 · NPPES record last updated Aug 6, 2024

Key facts

NPI
1821828633
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
205 14TH Ave E
Sartell, MN 56377-4500
Phone
(320) 774-3436
NPI assigned
Aug 6, 2024
Sex
Female
Sole proprietor
No

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Northway Academy, Inc. Past
since Aug 11, 2024
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

205 14TH Ave E
Sartell, MN 56377-4500

Mailing address

205 14TH Ave E
Sartell, MN 56377-4500
Phone (320) 774-3436

Other providers in Sartell, MN

All providers in Sartell, MN · Behavior Technician in Minnesota

Sources for this page

Verify at the official NPI Registry.