Provider Demographics
NPI:1285085530
Name:BLUNT, SAKINA FAHEEMAH (MS)
Entity type:Individual
Prefix:MRS
First Name:SAKINA
Middle Name:FAHEEMAH
Last Name:BLUNT
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4615 HILTON CORPORATE DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43232-4151
Mailing Address - Country:US
Mailing Address - Phone:614-729-2024
Mailing Address - Fax:
Practice Address - Street 1:701 KENMORE AVE
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-5737
Practice Address - Country:US
Practice Address - Phone:540-322-5424
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-28
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0704014963101YM0800X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0704014963Medicaid
OH2847496Medicaid