Provider Demographics
NPI:1376377374
Name:BLAIR CLINICAL SERVICES PLLC
Entity type:Organization
Organization Name:BLAIR CLINICAL SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BLAIR
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:LCMHC
Authorized Official - Phone:980-351-4216
Mailing Address - Street 1:8045 CORPORATE CENTER DR STE 3011-I
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28226-4555
Mailing Address - Country:US
Mailing Address - Phone:980-351-4216
Mailing Address - Fax:980-217-6527
Practice Address - Street 1:8045 CORPORATE CENTER DR STE 3011-I
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28226-4555
Practice Address - Country:US
Practice Address - Phone:980-351-4216
Practice Address - Fax:980-217-6527
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-30
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty