MEDICARE: ABDISAMED MOHAMED

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor		OH

General Provider Information

NPI Number	:	1063230571
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABDISAMED MOHAMED

Provider Business Mailing Address
First Line	:	3350 CLEVELAND AVE STE 1936
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43224-3677
Country	:	US
Telephone Number	:	614-615-2858
Fax Number	:

Provider Business Practice Location Address
First Line	:	5345 VALLEY LN E
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43231-3114
Country	:	US
Telephone Number	:	614-592-8547
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/02/2024
Last Update Date	:	11/11/2024

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Directions to “ ABDISAMED MOHAMED ” Practice Location

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