Healthcare Provider Details

I. General information

NPI: 1659639813
Provider Name (Legal Business Name): MASUMA RASHEED PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/25/2012
Last Update Date: 07/20/2020
Certification Date: 07/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1244 W OHIO ST UNIT 2W
CHICAGO IL
60642-6276
US

IV. Provider business mailing address

1244 W OHIO ST UNIT 2W
CHICAGO IL
60642-6276
US

V. Phone/Fax

Practice location:
  • Phone: 312-625-0366
  • Fax:
Mailing address:
  • Phone: 312-625-0366
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number64554
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number64554
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code102L00000X
TaxonomyPsychoanalyst
License Number64554
License Number StateTX
# 4
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: