Provider Demographics
NPI:1477675056
Name:KAREEM, SHAZIA (LPC)
Entity Type:Individual
Prefix:MS
First Name:SHAZIA
Middle Name:
Last Name:KAREEM
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 DAY SCHOOL DR
Mailing Address - Street 2:
Mailing Address - City:MIDDLEFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06455-1276
Mailing Address - Country:US
Mailing Address - Phone:475-238-4509
Mailing Address - Fax:
Practice Address - Street 1:25 DAY SCHOOL DR
Practice Address - Street 2:
Practice Address - City:MIDDLEFIELD
Practice Address - State:CT
Practice Address - Zip Code:06455-1276
Practice Address - Country:US
Practice Address - Phone:475-238-4509
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2021-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002313101YP2500X
CT002312101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1639521305OtherANTHEM
CT1639521305Medicaid