Provider Demographics
NPI:1336765874
Name:BEHAVIORAL HEALTH ALLIANCE
Entity Type:Organization
Organization Name:BEHAVIORAL HEALTH ALLIANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST//OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MUNA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOHAMED
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:952-652-3439
Mailing Address - Street 1:5871 CEDAR LAKE RD S STE 202
Mailing Address - Street 2:
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55416-1479
Mailing Address - Country:US
Mailing Address - Phone:952-652-3439
Mailing Address - Fax:
Practice Address - Street 1:5871 CEDAR LAKE RD S STE 202
Practice Address - Street 2:
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55416-1479
Practice Address - Country:US
Practice Address - Phone:952-652-3439
Practice Address - Fax:952-674-6270
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-21
Last Update Date:2020-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty