Provider Demographics
NPI:1215550124
Name:AHMED, ZEBUNNESSA (LCSW)
Entity Type:Individual
Prefix:
First Name:ZEBUNNESSA
Middle Name:
Last Name:AHMED
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 1:12212 W MOHAVE ST
Mailing Address - Street 2:
Mailing Address - City:AVONDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85323-8198
Mailing Address - Country:US
Mailing Address - Phone:623-203-4247
Mailing Address - Fax:
Practice Address - Street 1:12212 W MOHAVE ST
Practice Address - Street 2:
Practice Address - City:AVONDALE
Practice Address - State:AZ
Practice Address - Zip Code:85323-8198
Practice Address - Country:US
Practice Address - Phone:623-203-4247
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-26
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLMSW-175781041C0700X
AZLCSW-214321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical