Provider Demographics
NPI:1538789425
Name:KHURSHEED, AISHAH NAOMI (LMFT, LPC)
Entity type:Individual
Prefix:
First Name:AISHAH
Middle Name:NAOMI
Last Name:KHURSHEED
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Gender:
Credentials:LMFT, LPC
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Other - First Name:
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Mailing Address - Street 1:739 THIMBLE SHOALS BLVD
Mailing Address - Street 2:STE 704 A/B
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606
Mailing Address - Country:US
Mailing Address - Phone:757-897-5756
Mailing Address - Fax:757-765-6743
Practice Address - Street 1:739 THIMBLE SHOALS BLVD
Practice Address - Street 2:STE 704 A/B
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606
Practice Address - Country:US
Practice Address - Phone:757-897-5756
Practice Address - Fax:757-765-6743
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-21
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0717001597101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA812562189OtherBLACK PINE COUNSELING LLC