Provider Demographics
NPI:1851890313
Name:AHMAD, MAUDIA DELLSHAWN (LCSWA)
Entity Type:Individual
Prefix:
First Name:MAUDIA
Middle Name:DELLSHAWN
Last Name:AHMAD
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 E 3RD ST
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27889-4923
Mailing Address - Country:US
Mailing Address - Phone:252-362-3144
Mailing Address - Fax:
Practice Address - Street 1:105 E 3RD ST
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:NC
Practice Address - Zip Code:27889-4923
Practice Address - Country:US
Practice Address - Phone:252-362-3144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-09
Last Update Date:2018-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0117481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical