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NPI Code Detail

MEDICARE: SAMIRA MOHAMED ADAM SOCIAL WORKER

MEDICARE: SAMIRA MOHAMED ADAM SOCIAL WORKER
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
11041C0700XClinical Social Worker29314MN

General Provider Information

NPI Number : 1417435264
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMIRA MOHAMED ADAM SOCIAL WORKER
Provider Business Mailing Address
First Line : 9976 HAMLET LN S
Second Line :
City : COTTAGE GROVE
State : MN
Zip : 55016-3878
Country : US
Telephone Number : 651-434-7551
Fax Number :
Provider Business Practice Location Address
First Line : 2400 PARK AVE
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55404-3713
Country : US
Telephone Number : 888-881-8261
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/03/2018
Last Update Date : 06/01/2026

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Directions to “ SAMIRA MOHAMED ADAM SOCIAL WORKER” Practice Location

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