Healthcare Provider Details

I. General information

NPI: 1447013321
Provider Name (Legal Business Name): MUHSIN AHMED LPCC, LADC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2024
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1415 LILAC DR N STE 260
GOLDEN VALLEY MN
55422-4545
US

IV. Provider business mailing address

2215 E LAKE ST
MINNEAPOLIS MN
55407-4385
US

V. Phone/Fax

Practice location:
  • Phone: 763-496-1516
  • Fax: 763-496-1554
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number4465
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number306224
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: