MEDICARE: SHAZEIN HEALING THERAPY

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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1407705353
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHAZEIN HEALING THERAPY

Provider Business Mailing Address
First Line	:	12301 NICOLLET AVE APT 2134
Second Line	:
City	:	BURNSVILLE
State	:	MN
Zip	:	55337-2865
Country	:	US
Telephone Number	:	763-306-4672
Fax Number	:

Provider Business Practice Location Address
First Line	:	12301 NICOLLET AVE APT 2134
Second Line	:
City	:	BURNSVILLE
State	:	MN
Zip	:	55337-2865
Country	:	US
Telephone Number	:	763-306-4672
Fax Number	:

Authorized Official
Title or Position	:	THERAPIST
Name	:	NASRA ALI FARAH
Credential	:	LICSW
Telephone Number	:	763-306-4672

Provider Enumeration Date	:	01/23/2026
Last Update Date	:	01/23/2026

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Directions to “SHAZEIN HEALING THERAPY ” Practice Location

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