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:
Health care specialties
| Specialty | Code | License # | 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 11 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1649345745 | NPPES |
| Connecticut | MEDICAID | 004235942 | |
| Connecticut | MEDICAID | 024905300 |
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