Provider Demographics
NPI:1245462167
Name:KHLEIF, SAMAR H (LCPC)
Entity type:Individual
Prefix:MRS
First Name:SAMAR
Middle Name:H
Last Name:KHLEIF
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3511 PINEY WOODS PL APT C302
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20724-5979
Mailing Address - Country:US
Mailing Address - Phone:301-362-7462
Mailing Address - Fax:
Practice Address - Street 1:5301 76TH AVE
Practice Address - Street 2:
Practice Address - City:LANDOVER HILLS
Practice Address - State:MD
Practice Address - Zip Code:20784-1703
Practice Address - Country:US
Practice Address - Phone:301-459-2121
Practice Address - Fax:301-459-0675
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-11
Last Update Date:2009-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC2123101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health