1538789425 NPI number — AISHAH NAOMI KHURSHEED LMFT, LPC

Table of content: AISHAH NAOMI KHURSHEED LMFT, LPC (NPI 1538789425)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538789425 NPI number — AISHAH NAOMI KHURSHEED LMFT, LPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KHURSHEED
Provider First Name:
AISHAH
Provider Middle Name:
NAOMI
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LMFT, LPC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1538789425
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/28/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
739 THIMBLE SHOALS BLVD
Provider Second Line Business Mailing Address:
STE 704 A/B
Provider Business Mailing Address City Name:
NEWPORT NEWS
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23606
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
757-897-5756
Provider Business Mailing Address Fax Number:
757-765-6743

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
739 THIMBLE SHOALS BLVD
Provider Second Line Business Practice Location Address:
STE 704 A/B
Provider Business Practice Location Address City Name:
NEWPORT NEWS
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23606
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
757-897-5756
Provider Business Practice Location Address Fax Number:
757-765-6743
Provider Enumeration Date:
04/21/2020

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  0717001597 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 812562189 . This is a "BLACK PINE COUNSELING LLC" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".




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