Provider Demographics
NPI:1073172516
Name:AHMED, SIDDIGA ABDELGADIR (LCSWA)
Entity Type:Individual
Prefix:MRS
First Name:SIDDIGA
Middle Name:ABDELGADIR
Last Name:AHMED
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 W CORNWALLIS DR
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27408-7036
Mailing Address - Country:US
Mailing Address - Phone:336-337-5469
Mailing Address - Fax:336-660-2563
Practice Address - Street 1:2100 W CORNWALLIS DR
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-7036
Practice Address - Country:US
Practice Address - Phone:336-337-5469
Practice Address - Fax:336-660-2563
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-09
Last Update Date:2019-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0129231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty