Kristin Blackburn LMSW PLLC

Primary specialty

Social WorkerTaxonomy code 104100000X

Legal business name

KRISTIN BLACKBURN LMSW PLLC

Practice address

1945 Pauline Blvd Ste 10
Ann Arbor, MI 48103-5047

Phone

(734) 994-1531

NPI assigned

Feb 17, 2025

Organization subpart

No

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

Authorized official

Name

Mary Beth Houpt

Title

Credentialing

Phone

(517) 676-9797

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Practitioners 4

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

• Kristin R Blackburn, MSW, LMSW

  • Clinical Social Worker
  • Ann Arbor, MI
  • NPI 1639499437
  Medicare reassignment NPD
• Carol Jane Deering, LMSW

  • Clinical Social Worker
  • Ann Arbor, MI
  • NPI 1063835387
  NPD
• Kathleen Ann Diehl, MSW

  • Clinical Social Worker
  • Ann Arbor, MI
  • NPI 1538388699
  NPD
• Kathleen Frances Sullivan, PH.D.

  • Clinical Psychologist
  • Ann Arbor, MI
  • NPI 1932199874
  NPD (past)

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

{
    "created_epoch": "1739750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739750400000",
    "number": "1386449031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10",
            "city": "MASON",
            "state": "MI",
            "postal_code": "488540010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1945 PAULINE BLVD STE 10",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481035047",
            "telephone_number": "734-994-1531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KRISTIN BLACKBURN LMSW PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-17",
        "last_updated": "2025-02-17",
        "certification_date": "2025-02-17",
        "status": "A",
        "authorized_official_last_name": "HOUPT",
        "authorized_official_first_name": "MARY BETH",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "517-676-9797"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shashikala Krishnan, D.D.S.
• Ramachandra Meera Krishnashastry, M.D
• Krista Gravatt LMSW, LLC
• Kristen Miner, LLC
• Kristie Wyler Therapy PLLC
• Kristin F. Nickodemus, DDS, PLC
• Kristin Kunes MSW, LLC
• Alexandra Kritzmacher, LMSW
• Tatyana D Krivchenya, MD
• Morgan Kroeger

• Social Worker in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2025; 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.