Husam Mackawi

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

Practice address

6385 Old Shady Oak Rd
Suite 250 Ofc 290
Eden Prairie, MN 55344

Phone

(720) 333-0215

NPI assigned

May 28, 2025

Sex

Unspecified or another gender identity

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• New Beginnings Autism Center

  • Early Intervention Provider Agency
  • Eden Prairie, MN
  • NPI 1790661403
  NPD Authorized official

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

{
    "created_epoch": "1748390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748390400000",
    "number": "1861285090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6385 OLD SHADY OAK RD",
            "address_2": "SUITE 250 OFC 290",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "55344",
            "telephone_number": "720-333-0215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6385 OLD SHADY OAK RD",
            "address_2": "SUITE 250 OFC 290",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "55344",
            "telephone_number": "720-333-0215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACKAWI",
        "first_name": "HUSAM",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2025-05-28",
        "last_updated": "2025-05-28",
        "certification_date": "2025-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chelsea Maag, AU.D.
• Alice Macdonald, MBCHB
• Christopher James Macdonald, MD, PHD
• Quincee Lynn Macgibbon, CNP
• Kalene Nicole Hayes Mach, DO
• Mackmiller Design Build (Home for Good)
• Shahzad Madanipour, M.D.
• Faith Mader
• Lora Madjar-Farley, MA
• Coleman Jensen Madland

• Clinical Child & Adolescent Psychologist in Eden Prairie, MN
• Providers in Eden Prairie, MN by specialty
• Clinical Child & Adolescent Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2025; 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.