Active NPI
Dean Albert Blackburn
- Mental Health Counselor
- South Easton, MA
National Provider Identifier
1164969754
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 15061
- Practice address
- 9 Kevins Way
South Easton, MA 02375-1284 - Phone
- (508) 930-6671
- NPI assigned
- Jan 20, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 15061 | MA | Primary |
Addresses
Primary practice location
9 Kevins Way
South Easton, MA 02375-1284
Mailing address
9 Kevins Way
South Easton, MA 02375-1284
Phone (508) 930-6671
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15061 | MA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1484870400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1485907200000",
"number": "1164969754",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9 KEVINS WAY",
"city": "SOUTH EASTON",
"state": "MA",
"postal_code": "023751284",
"telephone_number": "508-930-6671"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9 KEVINS WAY",
"city": "SOUTH EASTON",
"state": "MA",
"postal_code": "023751284",
"telephone_number": "508-930-6671"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACKBURN",
"first_name": "DEAN",
"middle_name": "ALBERT",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-01-20",
"last_updated": "2017-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MA",
"license": "15061",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Easton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.