Healthcare Provider Details

I. General information

NPI: 1003111840
Provider Name (Legal Business Name): AMINAH C. T. BRAHIM-JIMENEZ LISW-S
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2011
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

591 BOSTON MILLS RD STE 550
HUDSON OH
44236-1160
US

IV. Provider business mailing address

9826 WASHINGTON ST
CHAGRIN FALLS OH
44023-5401
US

V. Phone/Fax

Practice location:
  • Phone: 234-269-6200
  • Fax: 234-602-2192
Mailing address:
  • Phone: 440-708-0188
  • Fax: 440-708-0368

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI.0009413-SUPV
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: