Vance Wayne Blackwell Jr.

Individual provider Active NPI Mental Health Counselor · Bartlesville, OK

NPI 1588064604 · NPPES record last updated Aug 26, 2014

Key facts

NPI
1588064604
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
Practice address
2200 SE Washinton Blvd.
Bartlesville, OK 74006
Phone
(918) 457-0346
Fax
(918) 335-1119
NPI assigned
Aug 26, 2014
Sex
Male
Sole proprietor
Yes

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)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Yes

Addresses

Primary practice location

2200 SE Washinton Blvd.
Bartlesville, OK 74006

Mailing address

2200 SE Washinton Blvd.
Bartlesville, OK 74006
Phone (918) 457-0346

Other providers in Bartlesville, OK

All providers in Bartlesville, OK · Mental Health Counselor in Oklahoma

Sources for this page

Verify at the official NPI Registry.