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

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, LCSW

Title

Owner

Phone

(704) 365-7777

Specialties & licenses 1

Addresses

Other identifiers 1

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": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1982641114",
            "state": "NC"
        }
    ],
    "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.