MEDICARE: FIZAH MAHMOOD LCMHCA, NCC

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	A22435	NC

General Provider Information

NPI Number	:	1730048844
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FIZAH MAHMOOD LCMHCA, NCC

Provider Business Mailing Address
First Line	:	6001 GRABURNS FORD DR
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28269-7120
Country	:	US
Telephone Number	:	704-883-4043
Fax Number	:

Provider Business Practice Location Address
First Line	:	6001 GRABURNS FORD DR
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28269-7120
Country	:	US
Telephone Number	:	704-883-4043
Fax Number	:

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

Provider Enumeration Date	:	01/15/2026
Last Update Date	:	01/15/2026

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