Provider Demographics
NPI:1558195206
Name:AHMAD, ISRAR (MENTAL HEALTH COUNSL)
Entity type:Individual
Prefix:MR
First Name:ISRAR
Middle Name:
Last Name:AHMAD
Suffix:
Gender:M
Credentials:MENTAL HEALTH COUNSL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 ASHLAND ST APT 2
Mailing Address - Street 2:
Mailing Address - City:LYNN
Mailing Address - State:MA
Mailing Address - Zip Code:01905-2032
Mailing Address - Country:US
Mailing Address - Phone:857-381-1056
Mailing Address - Fax:
Practice Address - Street 1:102 ASHLAND ST APT 2
Practice Address - Street 2:
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01905-2032
Practice Address - Country:US
Practice Address - Phone:857-381-1056
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-27
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty