Provider Demographics
NPI:1275409930
Name:MAHMOUD, MAJED ABDI
Entity type:Individual
Prefix:
First Name:MAJED
Middle Name:ABDI
Last Name:MAHMOUD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1821 UNIVERSITY AVE W STE 138
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55104-2892
Mailing Address - Country:US
Mailing Address - Phone:612-328-9743
Mailing Address - Fax:612-328-9744
Practice Address - Street 1:1821 UNIVERSITY AVE W STE 138
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55104-2892
Practice Address - Country:US
Practice Address - Phone:612-328-9743
Practice Address - Fax:612-328-9744
Is Sole Proprietor?:No
Enumeration Date:2025-10-10
Last Update Date:2025-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician