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Provider Information for 1770880304


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Dr. HASSIEM A KAMBUI LMHC, NCC


Sex: Male

NPI: 1770880304
Last Updated: 2016-02-02
Certification Date:

Details

NameValue
NPI1770880304
Enumeration Date2011-02-16
NPI TypeNPI-1 Individual
Sole ProprietorNO
StatusActive
Mailing Address 2202 W PENSACOLA ST APT 46
TALLAHASSEE, FL 32304-3140
United States

Phone: 919-417-2640 | Fax:
 
Primary Practice Address 2202 W PENSACOLA ST APT 46
TALLAHASSEE, FL 32304-3140
United States

Phone: 919-417-2640 | Fax:
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 101YM0800X - Counselor - Mental HealthFL13861
No 101YP2500X - Counselor - ProfessionalNC8528