MEDICARE: IMAAN AHMED LPC

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	178.017665	IL
2	101YP2500X	Professional Counselor	23703	AZ

General Provider Information

NPI Number	:	1851019608
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IMAAN AHMED LPC

Provider Business Mailing Address
First Line	:	1925 W RIVER RD APT 14306
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85704-1793
Country	:	US
Telephone Number	:	630-290-8735
Fax Number	:

Provider Business Practice Location Address
First Line	:	6303 E TANQUE VERDE RD STE 210
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85715-3859
Country	:	US
Telephone Number	:	520-423-5600
Fax Number	:	520-822-8040

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

Provider Enumeration Date	:	08/18/2022
Last Update Date	:	06/02/2025

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Directions to “ IMAAN AHMED LPC” Practice Location

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