MEDICARE: EYE IN ME, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	101YP2500X	Professional Counselor
2	103T00000X	Psychologist
3	1041C0700X	Clinical Social Worker
4	106H00000X	Marriage & Family Therapist
5	174H00000X	Health Educator
6	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1033708144
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EYE IN ME, LLC

Provider Business Mailing Address
First Line	:	5557 BALTIMORE AVE STE 500-118
Second Line	:
City	:	HYATTSVILLE
State	:	MD
Zip	:	20781-1922
Country	:	US
Telephone Number	:	202-656-3064
Fax Number	:

Provider Business Practice Location Address
First Line	:	5557 BALTIMORE AVE STE 500-118
Second Line	:
City	:	HYATTSVILLE
State	:	MD
Zip	:	20781-1922
Country	:	US
Telephone Number	:	202-656-3064
Fax Number	:

Authorized Official
Title or Position	:	FOUNDER/CEO
Name	:	SHATIEA BLOUNT
Credential	:	LICSW, LCSW-C
Telephone Number	:	202-656-3064

Provider Enumeration Date	:	01/13/2021
Last Update Date	:	01/13/2021

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Directions to “EYE IN ME, LLC ” Practice Location

Language	Start Address	Practice Location

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