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NPI Code Detail

MEDICARE: SHAMSHAD AHMED PHD, LPC

MEDICARE: SHAMSHAD AHMED PHD, LPC
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
1101YP2500XProfessional CounselorLPC009920GA

General Provider Information

NPI Number : 1174974174
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHAMSHAD AHMED PHD, LPC
Provider Business Mailing Address
First Line : 205 S SKINNER AVE UNIT B
Second Line :
City : POOLER
State : GA
Zip : 31322-3221
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 205 S SKINNER AVE UNIT B
Second Line :
City : POOLER
State : GA
Zip : 31322-3221
Country : US
Telephone Number : 912-349-8043
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2016
Last Update Date : 01/20/2020

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