Elizabeth Blalock, LCSW,PA

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

ELIZABETH BLALOCK, LCSW,PA

Practice address

6809 Fairview Rd
Charlotte, NC 28210-4195

Phone

(704) 365-7777

Fax

(704) 554-9682

NPI assigned

Nov 28, 2017

Last updated

Nov 28, 2017By 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

Ms. Elizabeth S Blalock, LCSWNPI 1982641114

Title

Owner

Phone

(704) 365-7777

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.

• Elizabeth S Blalock, MSW, LCSW

  • Clinical Social Worker
  • Charlotte, NC
  • NPI 1982641114
  Authorized official Same address or phone

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

{
    "created_epoch": "1511827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1511827200000",
    "number": "1194239251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6809 FAIRVIEW RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282104195",
            "telephone_number": "704-365-7777",
            "fax_number": "704-554-9682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6809 FAIRVIEW RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282104195",
            "telephone_number": "704-365-7777",
            "fax_number": "704-554-9682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELIZABETH BLALOCK, LCSW,PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-28",
        "last_updated": "2017-11-28",
        "status": "A",
        "authorized_official_last_name": "BLALOCK",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-365-7777",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 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.

Verify at the official NPI Registry.