Provider Demographics
NPI:1992100093
Name:MOHAMMED BESHIR
Entity type:Organization
Organization Name:MOHAMMED BESHIR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONDITION CLINICAL PROF. COUNSELOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MOHAMMED
Authorized Official - Middle Name:ABDALLA
Authorized Official - Last Name:BESHIR
Authorized Official - Suffix:
Authorized Official - Credentials:MASTER COUNSELING
Authorized Official - Phone:207-317-7316
Mailing Address - Street 1:20 VAN VLIET ROAD
Mailing Address - Street 2:
Mailing Address - City:GORHAM
Mailing Address - State:ME
Mailing Address - Zip Code:04038-1200
Mailing Address - Country:US
Mailing Address - Phone:207-317-7316
Mailing Address - Fax:
Practice Address - Street 1:20 VAN VLIET DR
Practice Address - Street 2:
Practice Address - City:GORHAM
Practice Address - State:ME
Practice Address - Zip Code:04038-1200
Practice Address - Country:US
Practice Address - Phone:207-317-7316
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-31
Last Update Date:2014-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEXL4419251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health