Provider Demographics
NPI:1871859215
Name:BLACKMAN-DIARRA, GILLIAN ANDREA (LCSW-C)
Entity Type:Individual
Prefix:MRS
First Name:GILLIAN
Middle Name:ANDREA
Last Name:BLACKMAN-DIARRA
Suffix:
Gender:F
Credentials:LCSW-C
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Other - First Name:
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Mailing Address - Street 1:7015 DOLPHIN RD
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-3908
Mailing Address - Country:US
Mailing Address - Phone:240-354-8552
Mailing Address - Fax:301-735-5294
Practice Address - Street 1:6201 GREENBELT RD STE U4
Practice Address - Street 2:
Practice Address - City:BERWYN HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:20740-2361
Practice Address - Country:US
Practice Address - Phone:240-354-8552
Practice Address - Fax:301-735-5294
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-10
Last Update Date:2015-06-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MD175771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical