Provider Demographics
NPI:1184323057
Name:ALSAADI, OMAR (LPC)
Entity type:Individual
Prefix:MR
First Name:OMAR
Middle Name:
Last Name:ALSAADI
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 1:1613 GERMANTOWN AVE APT 105
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19122-3027
Mailing Address - Country:US
Mailing Address - Phone:724-590-0640
Mailing Address - Fax:
Practice Address - Street 1:1613 GERMANTOWN AVE APT 105
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19122-3027
Practice Address - Country:US
Practice Address - Phone:724-590-0640
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-28
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC012167101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional