Marilyn S Blackmon, MA LPC LCDC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC12619 Issued in TX

Practice address

1345 Campbell Rd
Houston, TX 77055

Phone

(713) 681-6680

Fax

(713) 467-0379

NPI assigned

Feb 1, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

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

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629115043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7712 BOBBITT LN",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77055",
            "telephone_number": "713-682-0262",
            "fax_number": "713-467-0379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1345 CAMPBELL RD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77055",
            "telephone_number": "713-681-6680",
            "fax_number": "713-467-0379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKMON",
        "first_name": "MARILYN",
        "middle_name": "S",
        "name_prefix": "Mrs.",
        "credential": "MA LPC LCDC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "LPC12619",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "LCDC4317",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Blackmon Fenwick, PH.D.
• Ana Blackmon, M.D.
• Brandy Michelle Blackmon
• Eme Blackmon
• James Blackmon, LPC
• Shanda Haley Blackmon, M.D., M.P.H.
• Stephen Harold Blackmore, PH.D.
• Briana Blacknell, LCSW
• Gwendolyn Yvonne Blacknell, LCDC
• Krysten P. Blackshear, LCSW

• Professional Counselor in Houston, TX
• Providers in Houston, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.