Samuel Austin Blackwood, CADC, CAS

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

C3881214 Issued in CA

Practice address

3148 Midway Dr
San Diego, CA 92110-4539

Phone

(619) 363-0853

Fax

(619) 362-9905

NPI assigned

Jan 28, 2008

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1201478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747353600000",
    "number": "1568649937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11596 CYPRESS CANYON PARK DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921313582",
            "telephone_number": "559-212-0389",
            "fax_number": "559-582-9201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3148 MIDWAY DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921104539",
            "telephone_number": "619-363-0853",
            "fax_number": "619-362-9905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKWOOD",
        "first_name": "SAMUEL",
        "middle_name": "AUSTIN",
        "name_prefix": "Mr.",
        "credential": "CADC, CAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-28",
        "last_updated": "2025-05-16",
        "certification_date": "2025-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "C3881214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Sandra Blackwood, CD
• Allison Blacutt, DACM. L.AC
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• Kent Alan Blade, M.D.
• Paige Blades Hanley

• Addiction (Substance Use Disorder) Counselor in San Diego, CA
• Providers in San Diego, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2025; 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.