MEDICARE: HALISI MUHAMMAD 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	101YP2500X	Professional Counselor	2014007785	MO

General Provider Information

NPI Number	:	1922425107
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HALISI MUHAMMAD LPC

Provider Business Mailing Address
First Line	:	6322 VIRGINIA AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63111-2434
Country	:	US
Telephone Number	:	314-397-9661
Fax Number	:

Provider Business Practice Location Address
First Line	:	5595 PAGE BLVD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63112-4118
Country	:	US
Telephone Number	:	314-503-6248
Fax Number	:	949-655-8524

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

Provider Enumeration Date	:	03/25/2014
Last Update Date	:	09/27/2020

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Directions to “ HALISI MUHAMMAD LPC” Practice Location

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