Erin Elizabeth Blackwell, LCSW

Individual provider Active NPI Clinical Social Worker · Warrensburg, MO

NPI 1043769839 · NPPES record last updated Sep 22, 2016

Key facts

NPI
1043769839
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
2014040085 (MO)
Practice address
407 E Russell Ave Ste A4
Warrensburg, MO 64093-1242
Phone
(660) 429-6678
Fax
(660) 429-6672
NPI assigned
Sep 22, 2016
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
2014040085MOMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Central Mo Behavioral Health LLC Clinical Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 2014040085 MO Yes

Addresses

Primary practice location

407 E Russell Ave Ste A4
Warrensburg, MO 64093-1242

Mailing address

PO Box C
Warrensburg, MO 64093-0768
Phone (660) 429-6678

Other names

  • Miss Erin Elizabeth Fuelling Former name

Other providers in Warrensburg, MO

All providers in Warrensburg, MO · Clinical Social Worker in Missouri

Sources for this page

Verify at the official NPI Registry.