Provider Demographics
NPI:1316697956
Name:I AM FAIZAH, LLC
Entity type:Organization
Organization Name:I AM FAIZAH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:FAIZAH
Authorized Official - Middle Name:
Authorized Official - Last Name:MAWUSI
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:317-250-1905
Mailing Address - Street 1:9307 CHERRY VALLEY CT
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46235-1139
Mailing Address - Country:US
Mailing Address - Phone:317-732-7102
Mailing Address - Fax:
Practice Address - Street 1:9307 CHERRY VALLEY CT
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46235-1139
Practice Address - Country:US
Practice Address - Phone:317-732-7102
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-26
Last Update Date:2022-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health