Tiarra Monique Abu-Bakr, LGPC

Individual provider Active NPI Mental Health Counselor · Clinton, MD

NPI 1730643198 · NPPES record last updated Jan 29, 2019

Key facts

NPI
1730643198
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
License
LGP9056 (MD)
Practice address
9015 Woodyard Rd
Clinton, MD 20735-4209
Phone
(301) 899-6222
NPI assigned
Jan 29, 2019
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
LGP9056MDMDMental Health Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LGP9056 MD Yes

Addresses

Primary practice location

9015 Woodyard Rd
Clinton, MD 20735-4209

Mailing address

10371 Stewards Chance LN
White Plains, MD 20695-3297
Phone (202) 270-7958

Other identifiers

IdentifierTypeStateIssuer
LGP9056OtherMDMARYLAND STATE

Other providers in Clinton, MD

All providers in Clinton, MD · Mental Health Counselor in Maryland

Sources for this page

Verify at the official NPI Registry.