Provider Demographics
NPI:1699266155
Name:ALAM, KHURSHEDA ANN (LMHC)
Entity type:Individual
Prefix:
First Name:KHURSHEDA
Middle Name:ANN
Last Name:ALAM
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:597 E 85TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11236-3248
Mailing Address - Country:US
Mailing Address - Phone:917-679-2012
Mailing Address - Fax:
Practice Address - Street 1:195 MONTAGUE ST FL 8
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-3631
Practice Address - Country:US
Practice Address - Phone:201-701-1657
Practice Address - Fax:212-368-4100
Is Sole Proprietor?:No
Enumeration Date:2018-05-21
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health