Provider Demographics
NPI:1811466675
Name:ABDULLAH, MOHAMMED (LCPC)
Entity type:Individual
Prefix:
First Name:MOHAMMED
Middle Name:
Last Name:ABDULLAH
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9748 WHISKEY RUN
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20723-1432
Mailing Address - Country:US
Mailing Address - Phone:716-860-3113
Mailing Address - Fax:
Practice Address - Street 1:14300 CHERRY LANE CT STE 203
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-4979
Practice Address - Country:US
Practice Address - Phone:716-860-3113
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-21
Last Update Date:2019-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health