Active NPI
Mindy Sue Blank, LGPC
- Professional Counselor
- Cumberland, MD
National Provider Identifier
1568076420
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LGP10677
- Practice address
- 308 Virginia Ave
Cumberland, MD 21502-4559 - Phone
- (667) 600-2110
- NPI assigned
- Sep 8, 2020
- Last updated
- Sep 8, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LGP10677 | MD | Primary |
Addresses
Primary practice location
308 Virginia Ave
Cumberland, MD 21502-4559
Mailing address
308 Virginia Ave
Cumberland, MD 21502-4559
Phone (667) 600-2110
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LGP10677 | Medicaid | MD |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mblank@cc-md.org | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LGP10677 | MD | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1599523200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1599523200000",
"number": "1568076420",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "308 VIRGINIA AVE",
"city": "CUMBERLAND",
"state": "MD",
"postal_code": "215024559",
"telephone_number": "667-600-2110"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "308 VIRGINIA AVE",
"city": "CUMBERLAND",
"state": "MD",
"postal_code": "215024559",
"telephone_number": "667-600-2110"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLANK",
"first_name": "MINDY",
"middle_name": "SUE",
"name_prefix": "Mrs.",
"credential": "LGPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-09-08",
"last_updated": "2020-09-08",
"certification_date": "2020-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MD",
"license": "LGP10677",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "LGP10677",
"state": "MD"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mblank@cc-md.org",
"affiliation": "N",
"endpointDescription": "Work email address",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "308 Virginia Ave",
"city": "Cumberland",
"state": "MD",
"country_code": "US",
"postal_code": "215024559",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Cumberland, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2020; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.