MEDICARE: MS. BUSHRA IRAD ALI

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	33433	MN

General Provider Information

NPI Number	:	1821957036
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. BUSHRA IRAD ALI

Provider Business Mailing Address
First Line	:	11875 80TH AVE N APT 309
Second Line	:
City	:	MAPLE GROVE
State	:	MN
Zip	:	55369-4774
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11875 80TH AVE N APT 309
Second Line	:
City	:	MAPLE GROVE
State	:	MN
Zip	:	55369-4774
Country	:	US
Telephone Number	:	502-876-6738
Fax Number	:

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

Provider Enumeration Date	:	01/22/2026
Last Update Date	:	01/22/2026

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