Amie Blackburn, LCSW

Individual provider Active NPI Clinical Social Worker · Leesville, LA

NPI 1053709063 · NPPES record last updated Sep 8, 2023

Key facts

NPI
1053709063
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
11723 (LA)
Practice address
3353 University Pkwy
Leesville, LA 71446-9041
Phone
(337) 392-3800
NPI assigned
Dec 27, 2014
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

State licenses

LicenseStateTypeSpecialty
11723LAMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 11723 LA Yes

Addresses

Primary practice location

3353 University Pkwy
Leesville, LA 71446-9041

Mailing address

3353 University Pkwy
Leesville, LA 71446-9041
Phone (337) 392-3800

Other providers in Leesville, LA

All providers in Leesville, LA · Clinical Social Worker in Louisiana

Sources for this page

Verify at the official NPI Registry.