Joan Bancvetz Blackman, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

17053 Issued in MN

Practice address

2800 University Ave SE
Minneapolis, MN 55414-3232

Phone

(612) 331-4429

NPI assigned

Aug 13, 2009

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1250121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1083846711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "313 MADISON AVE S",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "55343",
            "telephone_number": "952-931-9885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 UNIVERSITY AVE SE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554143232",
            "telephone_number": "612-331-4429"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2925 Chicago Ave",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554071321",
            "country_code": "US",
            "telephone_number": "866-603-0016",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLACKMAN",
        "first_name": "JOAN",
        "middle_name": "BANCVETZ",
        "name_prefix": "Mrs.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-13",
        "last_updated": "2026-07-13",
        "certification_date": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "17053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kiley Elizabeth Black, NP
• Meagan Black
• Sabrina Marie Black, PHARMD
• Kathryne Johanne Blackburn, PA-C
• Caren J Blacker, MBCHB
• Alexandria Denise Blackmon, N.P.
• Emily Blacksher, PT, DPT
• Kristine Ann Blackstone, LMFT
• Natalia Mary Blackstone
• Charles D Blackwell III, MD

• Clinical Social Worker in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.