Provider Demographics
NPI:1205456027
Name:MOHAMED, MOHAMED ABDELSALAM (LMSW)
Entity type:Individual
Prefix:
First Name:MOHAMED
Middle Name:ABDELSALAM
Last Name:MOHAMED
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32841 MIDDLEBELT RD STE 403
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-1714
Mailing Address - Country:US
Mailing Address - Phone:248-851-7739
Mailing Address - Fax:
Practice Address - Street 1:32841 MIDDLEBELT RD STE 403
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-1714
Practice Address - Country:US
Practice Address - Phone:248-851-7739
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-22
Last Update Date:2020-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011059851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical