Blakey Weaver Counseling Center Inc

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

BLAKEY WEAVER COUNSELING CENTER INC

Practice address

129 N Saratoga St Ste 1
Suffolk, VA 23434-5255

Phone

(757) 539-5353

Fax

(757) 539-5399

NPI assigned

Mar 26, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Kawanna Evette Ward-Hall, DCC, LCSW

Title

Chairman

Phone

(757) 395-0472

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kawanna Evette Ward, LCSW, CSAC, CSOTP

  • Clinical Social Worker
  • Portsmouth, VA
  • NPI 1043515331

  Clinical, VA

  Medicare reassignment NPD

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

{
    "created_epoch": "1553558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693958400000",
    "number": "1245791995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 N SARATOGA ST STE 1",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234345255",
            "telephone_number": "757-539-5353",
            "fax_number": "757-539-5399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 N SARATOGA ST STE 1",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234345255",
            "telephone_number": "757-539-5353",
            "fax_number": "757-539-5399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLAKEY WEAVER COUNSELING CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-26",
        "last_updated": "2023-09-06",
        "status": "A",
        "authorized_official_last_name": "WARD-HALL",
        "authorized_official_first_name": "KAWANNA",
        "authorized_official_middle_name": "EVETTE",
        "authorized_official_title_or_position": "CHAIRMAN",
        "authorized_official_telephone_number": "757-395-0472",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DCC, LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Randall L Bittner, DMD
• Melanie Bjorkman, FNP-C
• Myria Gunn Black, NP-C
• Michael Clarence Blake, M.D.
• Samantha Diane Blake, CCC-SLP
• Leigh J Blakiston, DDS
• Melody Blanco, FNP
• Blessed Keepers Home Health Care
• Cassidy G Blevins, OTD
• Wendell Blow

• All providers in Suffolk, VA
• Community/Behavioral Health Agency in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.