Provider Demographics
NPI:1831387828
Name:BLAIR, TERRI SZEPESI (LPC)
Entity type:Individual
Prefix:
First Name:TERRI
Middle Name:SZEPESI
Last Name:BLAIR
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 1:465 SAIRS AVE
Mailing Address - Street 2:APT. 9
Mailing Address - City:LONG BRANCH
Mailing Address - State:NJ
Mailing Address - Zip Code:07740-5657
Mailing Address - Country:US
Mailing Address - Phone:732-859-2942
Mailing Address - Fax:
Practice Address - Street 1:465 SAIRS AVE
Practice Address - Street 2:APT. 9
Practice Address - City:LONG BRANCH
Practice Address - State:NJ
Practice Address - Zip Code:07740-5657
Practice Address - Country:US
Practice Address - Phone:732-859-2942
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-04
Last Update Date:2007-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00213000101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ37PC00213000OtherPROFESSIONAL COUNSELOR