Michael Blackburn, BA, RC, MFA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

505 29TH St SE
Chartley House
Auburn, WA 98002-7541

Phone

(253) 876-7650

Fax

(253) 876-7651

NPI assigned

Jan 22, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Arts, Master of Fine Arts

State licenses

Practice roles

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.

• Sound

  • Mental Illness Community Based Residential Treatment Facility
  • Auburn, WA
  • NPI 1053971234
  NPD (past)
• Sound

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Tukwila, WA
  • NPI 1780774950
  NPD (past)

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540944000000",
    "number": "1114071891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 SW HOLDEN ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981263505",
            "telephone_number": "206-933-7299",
            "fax_number": "206-933-7250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 29TH ST SE",
            "address_2": "CHARTLEY HOUSE",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980027541",
            "telephone_number": "253-876-7650",
            "fax_number": "253-876-7651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKBURN",
        "first_name": "MICHAEL",
        "credential": "BA, RC, MFA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-22",
        "last_updated": "2018-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WA",
            "license": "RC00025589",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stewart Craig Birse, MD
• Prossie Lunkuse Birungi
• Carley Bishop
• Katherine Bitz
• BJT Behavioral Health Center
• Michael Todd Blackburn, M.A., CCC-SLP
• Sue Ellen Blackwell, MACFT
• Monvelia Theresa Blair, ARNP
• Camille Louise Blankenship
• Roger M Blauvelt, MD

• Mental Health Counselor in Auburn, WA
• Providers in Auburn, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.