Provider Demographics
NPI:1720231079
Name:BLAIR, SHIREEN (LCPC, NCC, BCPC)
Entity Type:Individual
Prefix:MS
First Name:SHIREEN
Middle Name:
Last Name:BLAIR
Suffix:
Gender:F
Credentials:LCPC, NCC, BCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8583 SEASONS WAY
Mailing Address - Street 2:
Mailing Address - City:LANHAM SEABROOK
Mailing Address - State:MD
Mailing Address - Zip Code:20706-3820
Mailing Address - Country:US
Mailing Address - Phone:301-552-7647
Mailing Address - Fax:
Practice Address - Street 1:8583 SEASONS WAY
Practice Address - Street 2:
Practice Address - City:LANHAM SEABROOK
Practice Address - State:MD
Practice Address - Zip Code:20706-3820
Practice Address - Country:US
Practice Address - Phone:301-552-7647
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-30
Last Update Date:2008-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC1560101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional