Provider Demographics
NPI:1922156348
Name:BLAIR, LINDA A (MA, LMHC)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:A
Last Name:BLAIR
Suffix:
Gender:F
Credentials:MA, LMHC
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 193
Mailing Address - Street 2:
Mailing Address - City:NORTHBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:01534-0193
Mailing Address - Country:US
Mailing Address - Phone:508-234-2856
Mailing Address - Fax:
Practice Address - Street 1:8 CHURCH ST
Practice Address - Street 2:
Practice Address - City:WESTBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01581-1904
Practice Address - Country:US
Practice Address - Phone:508-366-4000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6073101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health