Provider Demographics
NPI:1609485598
Name:BLAIR, ERIN (MS, LMFT)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:BLAIR
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1950 DEKALB AVE STE E
Mailing Address - Street 2:
Mailing Address - City:SYCAMORE
Mailing Address - State:IL
Mailing Address - Zip Code:60178-3114
Mailing Address - Country:US
Mailing Address - Phone:630-570-0050
Mailing Address - Fax:
Practice Address - Street 1:1950 DEKALB AVE STE E
Practice Address - Street 2:
Practice Address - City:SYCAMORE
Practice Address - State:IL
Practice Address - Zip Code:60178-3114
Practice Address - Country:US
Practice Address - Phone:630-570-0050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-27
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL166001732106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist