Provider Demographics
NPI:1891092581
Name:BLOUNT, TAHEERA NADIYAH (LPC)
Entity Type:Individual
Prefix:MS
First Name:TAHEERA
Middle Name:NADIYAH
Last Name:BLOUNT
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 1:1322 SOUTHPOINT CROSSING DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-6608
Mailing Address - Country:US
Mailing Address - Phone:919-237-3174
Mailing Address - Fax:
Practice Address - Street 1:1322 SOUTHPOINT CROSSING DR
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-6608
Practice Address - Country:US
Practice Address - Phone:919-237-3174
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-16
Last Update Date:2011-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8317101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional