Provider Demographics
NPI:1669360830
Name:OKASH, NASTEHO IBRAHIM
Entity type:Individual
Prefix:
First Name:NASTEHO
Middle Name:IBRAHIM
Last Name:OKASH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 KILLEBREW DR STE 112
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55425-1871
Mailing Address - Country:US
Mailing Address - Phone:207-408-6684
Mailing Address - Fax:
Practice Address - Street 1:1701 AMERICAN BLVD E STE 19
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55425-1404
Practice Address - Country:US
Practice Address - Phone:207-408-6684
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-26
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health