Ali, Ayesha Mohamed

Ali, Ayesha Mohamed is an individual health care provider with primary practice located at 63311 Jamison St , Bend OR 97703-8288. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Social Worker, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Ali, Ayesha Mohamed can be contacted via phone (541) 322-7500.

Contact Information

Primary practice address
63311 Jamison St Bend OR 97703-8288
Phone: (541) 322-7500
Fax: (541) 322-7565
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 084586 Oregon
Behavioral Health & Social Service Providers / Social Worker 104100000X
Behavioral Health & Social Service Providers / Clinical 1041C0700X L10972 Oregon

Profile Details

NPI number 1770140881
LBN Legal business name Ali, Ayesha Mohamed
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date May 23rd, 2019
Last updated May 16th, 2022 - about 2 years ago

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 1770140881 NPPES
Oregon Other STB-A-10184107 CERTIFIED ASSOCIATE SEX OFFENDER THERAPIST

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