Provider Demographics
NPI:1861140618
Name:MOHAMUD, ARDA ABDI (LCSW)
Entity type:Individual
Prefix:MS
First Name:ARDA
Middle Name:ABDI
Last Name:MOHAMUD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 RESERVOIR ST STE 21&28
Mailing Address - Street 2:
Mailing Address - City:NEEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02494-3149
Mailing Address - Country:US
Mailing Address - Phone:571-297-5135
Mailing Address - Fax:
Practice Address - Street 1:46 BROCK ST
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MA
Practice Address - Zip Code:02135-2509
Practice Address - Country:US
Practice Address - Phone:571-297-5135
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-11
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA218697104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker