Provider Demographics
NPI:1285966085
Name:MUSTAPHA, ALIMATU SADIA (LPC; CSAC)
Entity type:Individual
Prefix:
First Name:ALIMATU
Middle Name:SADIA
Last Name:MUSTAPHA
Suffix:
Gender:F
Credentials:LPC; CSAC
Other - Prefix:MRS
Other - First Name:ALIMATU
Other - Middle Name:SADIA
Other - Last Name:MUSTAPHA-PALMER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:17844 OYSTER BAY CT
Mailing Address - Street 2:
Mailing Address - City:DUMFRIES
Mailing Address - State:VA
Mailing Address - Zip Code:22026-4529
Mailing Address - Country:US
Mailing Address - Phone:703-898-8760
Mailing Address - Fax:703-221-9105
Practice Address - Street 1:17844 OYSTER BAY CT
Practice Address - Street 2:
Practice Address - City:DUMFRIES
Practice Address - State:VA
Practice Address - Zip Code:22026-4529
Practice Address - Country:US
Practice Address - Phone:703-898-8760
Practice Address - Fax:703-221-9105
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-03
Last Update Date:2010-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701004492101Y00000X
DCPRC13771101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor