Provider Demographics
NPI:1124734678
Name:JAMA, HAMDI A (MSW, LICSW)
Entity type:Individual
Prefix:
First Name:HAMDI
Middle Name:A
Last Name:JAMA
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14591 GRAND AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55306-5725
Mailing Address - Country:US
Mailing Address - Phone:612-517-4095
Mailing Address - Fax:
Practice Address - Street 1:14591 GRAND AVE STE 202
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55306-5725
Practice Address - Country:US
Practice Address - Phone:612-517-4095
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-27
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN229121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical