Individual provider · Type 1 NPI
Shaniqua Blackman
Mental Health Counselor · Lake Villa, IL
NPI number
1063389336
Active
Practice location
600 W Grand Ave
Lake Villa, IL 60046-8034
Mailing address
11141 S Ashland Ave
Chicago, IL 60643-3513
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Counselor Primary | 101YM0800X | 180.017610 (IL) |
Mental Health Counselor: Definition to come...
2 other providers at this address
Other mental health counselor providers in Lake Villa
- Nicholas Rippentrop, MSMental Health Counselor Lake Villa, IL NPI 1295680304
- Jacqueline Castillo, LPCMental Health Counselor Lake Villa, IL NPI 1487962627
- Shontae L. FisherMental Health Counselor Lake Villa, IL NPI 1609621796
- Ramona C. HickeyMental Health Counselor Lake Villa, IL NPI 1699440446
- Jessica Leigh Lipinski, LSWMental Health Counselor Lake Villa, IL NPI 1720784333
- Alicia WadeMental Health Counselor Lake Villa, IL NPI 1750897997
- Suzan A. Washington, PhDMental Health Counselor Lake Villa, IL NPI 1770988750
- Jasmine WardMental Health Counselor Lake Villa, IL NPI 1861362519
About NPI 1063389336
Shaniqua Blackman's National Provider Identifier is 1063389336, issued on Oct 21, 2025. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Lake Villa, IL. The record was last updated on Oct 24, 2025.