Tighe Blackadar, MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LC17781 Issued in ME

Practice address

41 Depot St Ste 204
Bridgton, ME 04009-2298

Phone

(207) 241-4332

NPI assigned

Sep 10, 2020

Last updated

Oct 15, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Wild North Counseling LLC

  • Clinical Social Worker
  • Bridgton, ME
  • NPI 1174359012
  NPD Authorized official

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

{
    "created_epoch": "1599696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1508471095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 DEPOT ST STE 204",
            "city": "BRIDGTON",
            "state": "ME",
            "postal_code": "040092298",
            "telephone_number": "207-241-4332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 DEPOT ST STE 204",
            "city": "BRIDGTON",
            "state": "ME",
            "postal_code": "040092298",
            "telephone_number": "207-241-4332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKADAR",
        "first_name": "TIGHE",
        "name_prefix": "Mr.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-10",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC17781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bella Point, Inc. (Bella Point Bridgton)
• Linda A Bennett, CLINICAL COUNSELOR
• Paula M L Berube
• Birthwise
• Cindy Ann Black, LCSW
• Hans Boedeker, MD
• Karen S Bogdan, OT
• Maria L Brake, LMT
• Breathing Space LLC
• Audreigh Anna Brede, PT, DPT

• Clinical Social Worker in Bridgton, ME
• Providers in Bridgton, ME by specialty
• Clinical Social Worker in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2024; 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.