MEDICARE: MENTAL HEALTH ADVOCATES LLC

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	261QM0850X	Adult Mental Health Clinic/Center

General Provider Information

NPI Number	:	1407553159
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MENTAL HEALTH ADVOCATES LLC

Provider Business Mailing Address
First Line	:	1330 LAGOON AVE # 401
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55408-2885
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1330 LAGOON AVE # 401
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55408-2885
Country	:	US
Telephone Number	:	952-262-6423
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	NASRA DAHIR
Credential	:
Telephone Number	:	614-843-1079

Provider Enumeration Date	:	02/13/2023
Last Update Date	:	10/23/2025

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