Jennifer N/a Blackwell, LPC ASSOCIATE

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

82944 Issued in TX

Practice address

3833 S Staples St
Corpus Christi, TX 78411-5201

Phone

(361) 852-9665

NPI assigned

Apr 16, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1618531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618531200000",
    "number": "1316528896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "467 UNIVERSITY DR",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784122743",
            "telephone_number": "361-765-5419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3833 S STAPLES ST",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784115201",
            "telephone_number": "361-852-9665"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2901 Ayers St",
            "address_purpose": "LOCATION",
            "city": "Corpus Christi",
            "state": "TX",
            "postal_code": "784043824",
            "country_code": "US",
            "telephone_number": "361-698-1586",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLACKWELL",
        "first_name": "JENNIFER",
        "middle_name": "N/A",
        "credential": "LPC ASSOCIATE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-16",
        "last_updated": "2021-04-16",
        "certification_date": "2021-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "82944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Javine Dale Bispott, MD
• Charles Lee Bivona, M.D.
• BKD Homewood Corpus Christi Propco, LLC (Brookdale Corpus Christi)
• BKD Personal Assistance Services LLC (Brookdale at Home Corpus Christi)
• Barbara Evelyn Black, APRN
• Nancy Blaich, LCSW
• Katricia Simone Blair, NP
• Savannah Blake, DC
• Jessica Blakeslee
• Blanca Lucia Gray MD PA

• Mental Health Counselor in Corpus Christi, TX
• Providers in Corpus Christi, TX by specialty
• Mental Health Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2021; 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.