Provider Demographics
NPI:1003515149
Name:IBRAHIM, YAASMEEN SIDDEEQA MUSLIMA (LCSW)
Entity Type:Individual
Prefix:
First Name:YAASMEEN SIDDEEQA
Middle Name:MUSLIMA
Last Name:IBRAHIM
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12400 SHADOW CREEK PKWY APT 202
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-7348
Mailing Address - Country:US
Mailing Address - Phone:630-890-1342
Mailing Address - Fax:
Practice Address - Street 1:5010 MAYFIELD RD STE 210
Practice Address - Street 2:
Practice Address - City:LYNDHURST
Practice Address - State:OH
Practice Address - Zip Code:44124-2692
Practice Address - Country:US
Practice Address - Phone:216-505-4774
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-27
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1097961041C0700X
OHI.22041661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical