MEDICARE: MUNA ALI MOHAMED MA, LPCC

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
1	101YM0800X	Mental Health Counselor	CC01758	MN

General Provider Information

NPI Number	:	1407353352
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MUNA ALI MOHAMED MA, LPCC

Provider Business Mailing Address
First Line	:	5871 CEDAR LAKE RD S STE 202
Second Line	:
City	:	SAINT LOUIS PARK
State	:	MN
Zip	:	55416-1479
Country	:	US
Telephone Number	:	952-652-3439
Fax Number	:

Provider Business Practice Location Address
First Line	:	1437 MARSHALL AVE STE 102
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55104-6345
Country	:	US
Telephone Number	:	612-532-8027
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/08/2018
Last Update Date	:	04/03/2025

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