Dyashiah Blackmon
Individual provider Active NPI Community Health Worker · Burton, MI
NPI 1447052600 · NPPES record last updated Mar 26, 2025
Key facts
- NPI
- 1447052600
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Community Health Worker 172V00000X
- Practice address
- 1173 S Packard Ave
Burton, MI 48509-2311 - Phone
- (833) 478-9464
- NPI assigned
- Mar 26, 2025
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | Yes |
Addresses
Primary practice location
1173 S Packard Ave
Burton, MI 48509-2311
Mailing address
1173 S Packard Ave
Burton, MI 48509-2311
Phone (833) 478-9464
Other providers in Burton, MI
- Dawn Marie Bierek
- Christie Bigelow
- Ty Spencer Bigelow
- Nastaran Biriji
- Jill Black
- Cathy Junelle Blair
- Iyana Denee Blanks-Prater
- Blue Lakes Behavioral Health, LLC
- Adam J Boice
- David Charles Bonadeo
All providers in Burton, MI · Community Health Worker in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 26, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.