David Howarth Blackwell, LPC, LSAC

Individual provider Active NPI Professional Counselor · Highland, UT

NPI 1306067459 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1306067459
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
342505-6004 (UT)
Practice address
11188 N 6000 W
Highland, UT 84003-9438
Phone
(801) 756-7403
NPI assigned
May 2, 2007
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
342505-6004UTMDProfessional Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 342505-6004 UT Yes

Addresses

Primary practice location

11188 N 6000 W
Highland, UT 84003-9438

Mailing address

11188 N 6000 W
Highland, UT 84003-9438
Phone (801) 756-7403

Other providers in Highland, UT

All providers in Highland, UT · Professional Counselor in Utah

Sources for this page

Verify at the official NPI Registry.