Brenda S Blackwell
Individual provider Active NPI Counselor · Archdale, NC
NPI 1487975165 · NPPES record last updated Jun 17, 2010
Key facts
- NPI
- 1487975165
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- Practice address
- 205 Balfour Dr
Archdale, NC 27263-3117 - Phone
- (800) 422-8034
- NPI assigned
- Jun 17, 2010
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | Yes |
Addresses
Primary practice location
205 Balfour Dr
Archdale, NC 27263-3117
Mailing address
284 Executive Park Dr
Concord, NC 28025-1831
Phone (704) 939-1118
Other providers in Archdale, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 17, 2010. 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.