Provider Demographics
NPI:1508003484
Name:AHMED, NADEEM (LCP)
Entity Type:Individual
Prefix:
First Name:NADEEM
Middle Name:
Last Name:AHMED
Suffix:
Gender:M
Credentials:LCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9101 WASHINGTON STREET
Mailing Address - Street 2:
Mailing Address - City:AMELIA CH
Mailing Address - State:VA
Mailing Address - Zip Code:23002
Mailing Address - Country:US
Mailing Address - Phone:804-561-5057
Mailing Address - Fax:434-392-9221
Practice Address - Street 1:9101 WASHINGTON STREET
Practice Address - Street 2:
Practice Address - City:AMELIA CH
Practice Address - State:VA
Practice Address - Zip Code:23002
Practice Address - Country:US
Practice Address - Phone:804-561-5057
Practice Address - Fax:434-392-9221
Is Sole Proprietor?:No
Enumeration Date:2009-01-14
Last Update Date:2009-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810004047103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical