Evelyn Nida Blanford, M.A.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6301007707 Issued in MI

Practice address

420 W 5TH Ave
Flint, MI 48503-2445

Phone

(810) 496-5305

Fax

(810) 762-5234

NPI assigned

Jul 5, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184654865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 MONTCLAIR AVE",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485032221",
            "telephone_number": "810-232-1689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 W 5TH AVE",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485032445",
            "telephone_number": "810-496-5305",
            "fax_number": "810-762-5234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANFORD",
        "first_name": "EVELYN",
        "middle_name": "NIDA",
        "name_prefix": "Ms.",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301007707",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS-007741-L",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WV",
            "license": "315",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Denise Blade, LPN
• Jacqueline Blair, AAS, CADC-M, CCS-M
• Joy Blair
• Shyra Shaquanda Blake
• Delores Blakely, BA
• Bobby Jo Blanton
• Kelsey Blegen
• Kristin Marie Blevins, LMSW
• Cathy Oberg Blight, MD
• Brooke Tokaye Bliss, R.PH.

• Clinical Psychologist in Flint, MI
• Providers in Flint, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.