Provider Demographics
NPI:1982350740
Name:SALEEM, SHAMARI RASHIDA (LPC-IT)
Entity type:Individual
Prefix:
First Name:SHAMARI
Middle Name:RASHIDA
Last Name:SALEEM
Suffix:
Gender:F
Credentials:LPC-IT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8413 N SERVITE DR UNIT 104
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53223-6202
Mailing Address - Country:US
Mailing Address - Phone:414-241-3487
Mailing Address - Fax:
Practice Address - Street 1:8413 N SERVITE DR UNIT 104
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53223-6202
Practice Address - Country:US
Practice Address - Phone:414-241-3487
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-01
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5214226101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty