Andrea K Blackwell, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSW008540 Issued in GA

Practice address

124 Mallard St.
Greenville, SC 29601-4046

Phone

(864) 241-1040

Fax

(864) 241-1215

NPI assigned

Mar 10, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Highland Rivers Community Service BoardGroup PAC ID 9032000245, 57 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Highland Rivers Community Service Board

  • Community/Behavioral Health Agency
  • Dalton, GA
  • NPI 1447256243
  Medicare reassignment Care Compare group NPD
• Highland Rivers CSB

  • Community/Behavioral Health Agency
  • Dalton, GA
  • NPI 1164585543
  NPD

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

{
    "created_epoch": "1268179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680220800000",
    "number": "1457674111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1449 TEMPLE RD",
            "city": "BREMEN",
            "state": "GA",
            "postal_code": "301102378",
            "telephone_number": "770-537-2367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 MALLARD ST.",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296014046",
            "telephone_number": "864-241-1040",
            "fax_number": "864-241-1215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKWELL",
        "first_name": "ANDREA",
        "middle_name": "K",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-10",
        "last_updated": "2023-03-31",
        "certification_date": "2023-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW008540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Corinne Blackmon, MA, LCMHC, LPC
• Kevin Neely Blackmon, M.D.
• Charlaina Blackstock
• Barry C Blackston, M.D.
• Alice Blackwell, M.ED, E.DS., LPC-A
• Ann Kathryn Blackwell, RN
• Caitlin Alexandria Blackwell, MD STUDENT
• Hanna Blackwell, RBT
• Richard H. Blackwell, O.D.
• Roger D Blackwell, PHARMACIST

• Clinical Social Worker in Greenville, SC
• Providers in Greenville, SC by specialty
• Clinical Social Worker in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.