Provider Demographics
NPI:1720848922
Name:MOHAMED, ISLAM (PLMHP)
Entity Type:Individual
Prefix:
First Name:ISLAM
Middle Name:
Last Name:MOHAMED
Suffix:
Gender:F
Credentials:PLMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 S 16TH ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68502-3704
Mailing Address - Country:US
Mailing Address - Phone:402-481-5268
Mailing Address - Fax:
Practice Address - Street 1:1640 LAKE ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68502-3734
Practice Address - Country:US
Practice Address - Phone:402-481-5268
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-22
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health