Christian A Blackwell

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SL06659700 Issued in NJ

Practice address

274 Boyden Ave
Maplewood, NJ 07040-3010

Phone

(201) 407-3977

NPI assigned

Sep 6, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1662422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662422400000",
    "number": "1457072654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 S ORANGE AVE # 1164",
            "city": "SOUTH ORANGE",
            "state": "NJ",
            "postal_code": "070791702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "274 BOYDEN AVE",
            "city": "MAPLEWOOD",
            "state": "NJ",
            "postal_code": "070403010",
            "telephone_number": "201-407-3977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKWELL",
        "first_name": "CHRISTIAN",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-06",
        "last_updated": "2022-09-06",
        "certification_date": "2022-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "NJ",
            "license": "44SL06659700",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SL06659700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cblackwe@somsd.k12.nj.us",
            "affiliation": "N",
            "address_1": "274 Boyden Ave",
            "city": "Maplewood",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "070403010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Colin A Bethel, MD
• Omar M. Bey, M.D.
• Nishith Bhattacharyya, MD
• Jacqueline Bilikiewicz, LMHC
• Bill Powell, MSW, PA
• Zoe E. Blanchard, MSW, LSW
• Kenneth B Blatt, M.D.
• Peter Blumenthal, MD, MPH
• Susannah Bochner, FNP
• Allison Bonanno, MS NUTRITION

• Clinical Social Worker in Maplewood, NJ
• Providers in Maplewood, NJ by specialty
• Clinical Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2022; 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.