Provider Demographics
NPI:1801187281
Name:SIDDIQUI, NADIA IRUM (LPC)
Entity Type:Individual
Prefix:
First Name:NADIA
Middle Name:IRUM
Last Name:SIDDIQUI
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:PO BOX 19581
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77496-9581
Mailing Address - Country:US
Mailing Address - Phone:601-880-9332
Mailing Address - Fax:
Practice Address - Street 1:2245 TEXAS DR STE 300
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-1468
Practice Address - Country:US
Practice Address - Phone:832-799-2657
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-20
Last Update Date:2018-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1584101YP2500X
TX78339101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional