Stephen Daniel Blackman, B.A.

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Mason City, IA

NPI 1073974895 · NPPES record last updated Mar 8, 2016

Key facts

NPI
1073974895
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
Practice address
320 N Eisenhower Ave
Mason City, IA 50401-1521
Phone
(641) 243-7235
NPI assigned
Mar 8, 2016
Sex
Male
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
Credentials
Bachelor of Arts

Specialties & licenses

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

Addresses

Primary practice location

320 N Eisenhower Ave
Mason City, IA 50401-1521

Mailing address

320 N Eisenhower Ave
Mason City, IA 50401-1521
Phone (641) 243-7235

Other providers in Mason City, IA

All providers in Mason City, IA · Addiction (Substance Use Disorder) Counselor in Iowa

Sources for this page

Verify at the official NPI Registry.