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General NPI Number Information
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NPI Number | 1184359887
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Entity Type | Individual
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Provider Name | SHUKRI BASHIR LPCC
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Gender | Female
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Dates
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Enumeration Date | 07/18/2022
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Last Update Date | 07/18/2022
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Provider Practice Location Address
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Address Line | 1821 UNIVERSITY AVE W STE 107-30
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City | SAINT PAUL
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State | MN
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Zip | 55104-0049
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Country | US
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Telephone | 651-497-6593
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Fax |
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Provider Business Mailing Address
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Address Line | 1821 UNIVERSITY AVE W STE 107-30
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City | SAINT PAUL
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State | MN
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Zip | 55104-0049
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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