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NPI Code Detail

MEDICARE: DR. SYIDAH ABDULLAH LPC-MHSP

MEDICARE: DR. SYIDAH ABDULLAH LPC-MHSP
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
1101Y00000XCounselor4731TN

General Provider Information

NPI Number : 1093310161
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SYIDAH ABDULLAH LPC-MHSP
Provider Business Mailing Address
First Line : 1353 CARR AVE
Second Line :
City : MEMPHIS
State : TN
Zip : 38104-4864
Country : US
Telephone Number : 765-430-5068
Fax Number :
Provider Business Practice Location Address
First Line : 1314 PEABODY AVE
Second Line :
City : MEMPHIS
State : TN
Zip : 38104-3500
Country : US
Telephone Number : 901-321-5803
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/04/2020
Last Update Date : 12/04/2020

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