Abdikadir, Ilyas A

Abdikadir, Ilyas A is an individual health care provider with primary practice located at 3617 E Lake St Ste J , Minneapolis MN 55406-2148. He recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Other Service Providers / Case Manager/Care Coordinator, Behavioral Health & Social Service Providers / Group Psychotherapy. Behavioral Health & Social Service Providers / Group Psychotherapy is his primary health care specialty. Abdikadir, Ilyas A can be contacted via phone (651) 398-6348.

Contact Information

Primary practice address
3617 E Lake St Ste J Minneapolis MN 55406-2148
Phone: (651) 398-6348
Fax: (763) 201-7979
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 2740 Minnesota
Other Service Providers / Case Manager/Care Coordinator 171M00000X
Behavioral Health & Social Service Providers / Group Psychotherapy 103TP2701X 2740 Minnesota

Profile Details

NPI number 1063729747
LBN Legal business name Abdikadir, Ilyas A
Credentials LPCC
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 1st, 2010
Last updated Apr 3rd, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063729747 NPPES
Minnesota Other 843569697 PSYCHOTHERAPY
Minnesota Other 922503090 PSYCHOTHERAPY

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