Provider Demographics
NPI:1982045456
Name:ALI, ABDUL RAHIM (BA CADC CCDP CET)
Entity Type:Individual
Prefix:MR
First Name:ABDUL RAHIM
Middle Name:
Last Name:ALI
Suffix:
Gender:M
Credentials:BA CADC CCDP CET
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1012 MCRAE LANE
Mailing Address - Street 2:
Mailing Address - City:LEWISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17837
Mailing Address - Country:US
Mailing Address - Phone:570-974-9465
Mailing Address - Fax:
Practice Address - Street 1:32 WHISPER CREEK
Practice Address - Street 2:SUITE 8
Practice Address - City:LEWISBURG
Practice Address - State:PA
Practice Address - Zip Code:17837
Practice Address - Country:US
Practice Address - Phone:570-974-9465
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-12
Last Update Date:2013-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)