Michelle L Blanton, SUDRC

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Boonville, NC

NPI 1013788231 · NPPES record last updated Jan 18, 2024

Key facts

NPI
1013788231
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
15478 (CA)
Practice address
1006 Shawn Rodney Dr
Boonville, NC 27011-8694
Phone
(910) 382-4117
NPI assigned
Jan 16, 2024
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 15478 CA Yes

Addresses

Primary practice location

1006 Shawn Rodney Dr
Boonville, NC 27011-8694

Mailing address

1006 Shawn Rodney Dr
Boonville, NC 27011-8694
Phone (910) 382-4117

Electronic endpoints

TypeEndpointUseAffiliation
FHIR URL kipuworks.com Health Information Exchange (HIE)

Other providers in Boonville, NC

All providers in Boonville, NC · Addiction (Substance Use Disorder) Counselor in North Carolina

Sources for this page

Verify at the official NPI Registry.