Individual provider Active NPI

Maftuha Abdulla Hassan

  • Rehabilitation Psychologist
  • Fridley, MN
National Provider Identifier
1841736493
Registry record updated Oct 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PsychologistTaxonomy code 103TR0400X
Practice address
8298 University Ave NE
Fridley, MN 55432-2896
Phone
(763) 742-0952
Fax
(763) 432-3857
NPI assigned
Jan 6, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Companion 372600000X
Rehabilitation Psychologist 103TR0400X Primary

Addresses

Primary practice location

8298 University Ave NE
Fridley, MN 55432-2896

Mailing address

8298 University Ave NE
Fridley, MN 55432-2896
Phone (763) 742-0952

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
Peaceful Adult Day Center LLC. Current Accepting new patients
Peaceful Home and Community Care LLC CurrentSince Oct 27, 2024 Accepting new patients

Locations

8298 University Ave NE
Fridley, MN 55432
Phone (763) 742-0952

6267 University Ave NE
Fridley, MN 55432
Phone (763) 742-0952

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": "1483660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729468800000",
    "number": "1841736493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8298 UNIVERSITY AVE NE",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554322896",
            "telephone_number": "763-742-0952",
            "fax_number": "763-432-3857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8298 UNIVERSITY AVE NE",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554322896",
            "telephone_number": "763-742-0952",
            "fax_number": "763-432-3857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASSAN",
        "first_name": "MAFTUHA",
        "middle_name": "ABDULLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-06",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "372600000X",
            "taxonomy_group": "",
            "desc": "Adult Companion",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TR0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fridley, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 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.