Provider Demographics
NPI:1235726712
Name:HAJI-MOHAMED, LUL ABDIRAHMAN (MSW, LICSW)
Entity Type:Individual
Prefix:
First Name:LUL
Middle Name:ABDIRAHMAN
Last Name:HAJI-MOHAMED
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3040 4TH AVE S
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55408-2409
Mailing Address - Country:US
Mailing Address - Phone:612-236-7980
Mailing Address - Fax:
Practice Address - Street 1:3040 4TH AVE S
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55408-2409
Practice Address - Country:US
Practice Address - Phone:612-236-7980
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-30
Last Update Date:2021-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN247621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty