Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Shaniqua Blackman

Individual provider Mental Health Counselor · NPI 1063389336

Shaniqua Blackman is a Mental Health Counselor in Lake Villa, Illinois. Practices as a sole proprietor. Licensed in Illinois.

Licensed in
IL
In the registry since
2025
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Practice location Address checks out

600 W Grand Ave
Lake Villa, IL 60046-8034
Phone: (847) 245-6276
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence 180.017610 (IL)

Record details

NPI number1063389336
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedOctober 21, 2025
Last updated in NPPESOctober 24, 2025
Certification dateOctober 21, 2025

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