Provider Demographics
NPI:1477168680
Name:NAUSHAD, FATHIMA HUMAIRA (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:FATHIMA
Middle Name:HUMAIRA
Last Name:NAUSHAD
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:MRS
Other - First Name:HUMAIRA
Other - Middle Name:FATHIMA
Other - Last Name:NAUSHAD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMHC
Mailing Address - Street 1:3508 KINGS COLLEGE PL APT 4D
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-1562
Mailing Address - Country:US
Mailing Address - Phone:347-926-8663
Mailing Address - Fax:
Practice Address - Street 1:3508 KINGS COLLEGE PL APT 4D
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-1562
Practice Address - Country:US
Practice Address - Phone:347-926-8663
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-14
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010592101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000000000000OtherNA