Jacqueline Kester Blair, M.ED., LGMFT

Individual provider Active NPI Marriage & Family Therapist · Owings Mills, MD

NPI 1447596770 · NPPES record last updated Dec 13, 2012

Key facts

NPI
1447596770
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
LGM447 (MD)
Practice address
20 Pleasant Ridge Dr
Suite a
Owings Mills, MD 21117-2560
Phone
(443) 928-3298
Fax
(410) 902-5941
NPI assigned
Dec 13, 2012
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
LGM447MDMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Teladoc Health Medical Group, P.a. Marriage & Family Therapist Current Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jacquelineblair@tdh.allscriptsdirect.net

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X LGM447 MD Yes

Addresses

Primary practice location

20 Pleasant Ridge Dr
Suite a
Owings Mills, MD 21117-2560

Mailing address

20 Pleasant Ridge Dr
Suite a
Owings Mills, MD 21117-2560
Phone (443) 928-3298

Other providers in Owings Mills, MD

All providers in Owings Mills, MD · Marriage & Family Therapist in Maryland

Sources for this page

Verify at the official NPI Registry.