Provider Demographics
NPI:1205965506
Name:MOHAMUD, FARTUN S (EDD, LMHC)
Entity type:Individual
Prefix:DR
First Name:FARTUN
Middle Name:S
Last Name:MOHAMUD
Suffix:
Gender:F
Credentials:EDD, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1499 FOREST HILL BLVD STE 115
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33406-6050
Mailing Address - Country:US
Mailing Address - Phone:561-475-1552
Mailing Address - Fax:877-317-9406
Practice Address - Street 1:1499 FOREST HILL BLVD STE 115
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33406-6050
Practice Address - Country:US
Practice Address - Phone:561-475-1552
Practice Address - Fax:877-317-9406
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-04
Last Update Date:2022-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 7718101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health