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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 26, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.