Provider Demographics
NPI:1336804848
Name:IBRAHIM, HUDA (LMSW)
Entity Type:Individual
Prefix:
First Name:HUDA
Middle Name:
Last Name:IBRAHIM
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4201 CARLISLE BLVD NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87107-4808
Mailing Address - Country:US
Mailing Address - Phone:057-171-3325
Mailing Address - Fax:
Practice Address - Street 1:7027 MONTGOMERY BLVD NE STE F
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-1529
Practice Address - Country:US
Practice Address - Phone:505-880-0100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-01
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical