Willis Edwin Blackmore, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

M-04831 Issued in NM

Practice address

1337 Gusdorf Road, Suites E & F
Taos, NM 87571-6489

Phone

(575) 758-4297

Fax

(575) 751-7237

NPI assigned

Jun 5, 2007

Last updated

Feb 1, 2012By the provider in NPPES

Sex

Male

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Nonviolence Works, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Taos, NM
  • NPI 1376777607
  NPD (past)

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

{
    "created_epoch": "1181001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328054400000",
    "number": "1386846715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4787 NDCBU",
            "city": "TAOS",
            "state": "NM",
            "postal_code": "875716032",
            "telephone_number": "505-737-0142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1337 GUSDORF ROAD, SUITES E & F",
            "city": "TAOS",
            "state": "NM",
            "postal_code": "875716489",
            "telephone_number": "575-758-4297",
            "fax_number": "575-751-7237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKMORE",
        "first_name": "WILLIS",
        "middle_name": "EDWIN",
        "name_prefix": "Mr.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-05",
        "last_updated": "2012-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "M-04831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Monica Bierge Casas, LCSW
• Josephine Binford, R.N.
• Jennifer Birge, RD
• Norah K. Bishop, PT
• Per G Bjorkman, MD
• Lilly-Marie Maita Blecher, N.D., DOM
• Blue Mountain Chiropractic Inc
• Joey Blue, LISW
• Bluebird, Inc.
• Kimberly A Boberschmidt, PHARMD

• Clinical Social Worker in Taos, NM
• Providers in Taos, NM by specialty
• Clinical Social Worker in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2012; 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.