Provider Demographics
NPI:1871007450
Name:AHMED, SUMAIYA (LCSW)
Entity Type:Individual
Prefix:
First Name:SUMAIYA
Middle Name:
Last Name:AHMED
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 803795
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75380-3795
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:14800 QUORUM DR
Practice Address - Street 2:STE 283
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75254-7073
Practice Address - Country:US
Practice Address - Phone:214-223-1568
Practice Address - Fax:214-223-1568
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-19
Last Update Date:2019-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX572191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical