Lynette Bush Blackwell

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

11 Willow St
Wheatley Heights, NY 11798-1829

Phone

(631) 920-6542

NPI assigned

Jan 21, 2017

Sex

Female

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

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

{
    "created_epoch": "1484956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484956800000",
    "number": "1508303116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 WILLOW ST",
            "city": "WHEATLEY HEIGHTS",
            "state": "NY",
            "postal_code": "117981829",
            "telephone_number": "631-920-6542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 WILLOW ST",
            "city": "WHEATLEY HEIGHTS",
            "state": "NY",
            "postal_code": "117981829",
            "telephone_number": "631-920-6542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSH BLACKWELL",
        "first_name": "LYNETTE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-21",
        "last_updated": "2017-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Fritza R. Charles

• Behavior Technician in Wheatley Heights, NY
• Providers in Wheatley Heights, NY by specialty
• Behavior Technician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2017; 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.