Delores Blackwell, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

069826 Issued in NY

Practice address

2265 5TH Avenue
Apt MH
New York, NY 10037

Phone

(917) 445-2023

NPI assigned

Oct 3, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Albert Ellis Institute

  • Cognitive & Behavioral Psychologist
  • New York, NY
  • NPI 1538211842
  NPD (past)

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292889600000",
    "number": "1366536641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2265 5TH AVE",
            "address_2": "APT MH",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100372019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2265 5TH AVENUE",
            "address_2": "APT MH",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10037",
            "telephone_number": "917-445-2023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKWELL",
        "first_name": "DELORES",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2010-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "069826",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "13399",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C006651",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW9004313",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erica Blacksburg, MS, RD, CDN
• Zoe Blacksin, MD
• Daryle Marc Blackstock, PHYSICIAN ASSISTANT
• Judith Blackstone, LMHC
• Robin Leigh Pavlich Blackstone, MD
• Princess Nailah Blackwell
• Renee Denise Blackwell, LMSW
• Bjorn Montevanne Blackwood, MD
• Dana Blackwood
• Jena Rae Blackwood, DPT

• Clinical Social Worker in New York, NY
• Providers in New York, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2010; 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.