Katherine Blackwell, LCSW - Life Services

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW9581 Issued in FL

Legal business name

KATHERINE BLACKWELL, LCSW - LIFE SERVICES

Practice address

2117 Stewart LN
Mount Dora, FL 32757-9507

Phone

(352) 409-4077

NPI assigned

Oct 12, 2012

Last updated

Oct 12, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Katherine Blackwell, LCSWNPI 1295964948

Title

Manager

Phone

(352) 409-4077

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Katherine Yu Blackwell, LCSW

  • Clinical Social Worker
  • Mount Dora, FL
  • NPI 1295964948
  NPD (past) Authorized official

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

{
    "created_epoch": "1350000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350000000000",
    "number": "1194077222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2117 STEWART LN",
            "city": "MOUNT DORA",
            "state": "FL",
            "postal_code": "327579507",
            "telephone_number": "352-409-4077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2117 STEWART LN",
            "city": "MOUNT DORA",
            "state": "FL",
            "postal_code": "327579507",
            "telephone_number": "352-409-4077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KATHERINE BLACKWELL, LCSW - LIFE SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-12",
        "last_updated": "2012-10-12",
        "status": "A",
        "authorized_official_last_name": "BLACKWELL",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "352-409-4077",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW9581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dorina Lea Kaplan
• Rachael Karam
• Tasneem Karar
• Kim P Karvasale, DMD
• Amer Kassas, APRN
• Kathryn Johnson
• Kellie Lynne Keene
• Peggy A Keene, RN, MA, LMHC
• Kelti Keister, M.A., BCBA, LBA
• Joanne M Keller, ARNP

• Clinical Social Worker in Mount Dora, FL
• Providers in Mount Dora, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2012; 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.