MEDICARE: AIDA SHAHGHASEMI MA

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	4697	MN

General Provider Information

NPI Number	:	1568100394
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AIDA SHAHGHASEMI MA

Provider Business Mailing Address
First Line	:	7201 METRO BLVD STE 550
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55439-1353
Country	:	US
Telephone Number	:	612-314-5017
Fax Number	:

Provider Business Practice Location Address
First Line	:	7201 METRO BLVD
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55439-1300
Country	:	US
Telephone Number	:	612-314-5017
Fax Number	:

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

Provider Enumeration Date	:	05/23/2022
Last Update Date	:	12/04/2025

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Directions to “ AIDA SHAHGHASEMI MA” Practice Location

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