Blair, Susan B.

Blair, Susan B. is an individual health care provider with primary practice located at 349 Main St Ste 1 , Gaithersburg MD 20878-5780. She recently has only one registered license in Behavioral Health & Social Service Providers / Marriage & Family Therapist, which is considered as her primary health care specialty. Blair, Susan B. can be contacted via phone (240) 273-4645.

Contact Information

Primary practice address
349 Main St Ste 1 Gaithersburg MD 20878-5780
Phone: (240) 273-4645
Fax: (301) 865-3264
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X LCM463 Maryland
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 0717001254 Virginia
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 000148 District of Columbia
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 3 West Virginia

Profile Details

NPI number 1649345745
LBN Legal business name Blair, Susan B.
Credentials LCMFT, CCDP
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 22nd, 2006
Last updated Apr 23rd, 2015 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1649345745 NPPES
Connecticut MEDICAID 004235942
Connecticut MEDICAID 024905300

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