Provider Demographics
NPI:1558767186
Name:KADIR, MALIK-HAKIM (LPC)
Entity Type:Individual
Prefix:
First Name:MALIK-HAKIM
Middle Name:
Last Name:KADIR
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29351 ST ANDREWS
Mailing Address - Street 2:
Mailing Address - City:LAKE ELSINORE
Mailing Address - State:CA
Mailing Address - Zip Code:92530-4374
Mailing Address - Country:US
Mailing Address - Phone:949-491-3795
Mailing Address - Fax:
Practice Address - Street 1:401 LAUREL AVE
Practice Address - Street 2:C 5
Practice Address - City:PINOLE
Practice Address - State:CA
Practice Address - Zip Code:94564-1965
Practice Address - Country:US
Practice Address - Phone:602-617-1536
Practice Address - Fax:510-231-8456
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-10
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA156031 IV101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)