Active NPI
Devon Anthony Blackwood, LCADC
- Addiction (Substance Use Disorder) Counselor
- Reisterstown, MD
National Provider Identifier
1336225077
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- LCA305
- Practice address
- 100 Owings Court
Ste 8
Reisterstown, MD 21136 - Phone
- (410) 526-7100
- Fax
- (410) 526-7138
- NPI assigned
- Oct 27, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | LCA305 | MD | Primary |
Addresses
Primary practice location
100 Owings Court
Ste 8
Reisterstown, MD 21136
Mailing address
10400 Ridgland Road
Ste 1
Cockeysville, MD 21030
Phone (410) 628-6120
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
8400 Corporate Dr
Landover, MD 20785-2238
Phone (301) 806-7750
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCA305 | MD | MD | Addiction (Substance Use Disorder) Counselor |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Substance Use Disorder Rehabilitation Clinic/Center
- Landover, MD
- NPI 1457162190
DC
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161907200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1336225077",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10400 RIDGLAND ROAD",
"address_2": "STE 1",
"city": "COCKEYSVILLE",
"state": "MD",
"postal_code": "21030",
"telephone_number": "410-628-6120",
"fax_number": "410-628-9825"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 OWINGS COURT",
"address_2": "STE 8",
"city": "REISTERSTOWN",
"state": "MD",
"postal_code": "21136",
"telephone_number": "410-526-7100",
"fax_number": "410-526-7138"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACKWOOD",
"first_name": "DEVON",
"middle_name": "ANTHONY",
"name_prefix": "Mr.",
"credential": "LCADC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "MD",
"license": "LCA305",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Reisterstown, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.