Kristin R Blackburn, MSW, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801067835 Issued in MI

Practice address

1945 Pauline Blvd
Ste. 10
Ann Arbor, MI 48103-5047

Phone

(734) 994-1531

NPI assigned

Jun 3, 2010

Last updated

Jun 3, 2010By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1993

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kristin Blackburn LMSW PLLC

  • Social Worker
  • Ann Arbor, MI
  • NPI 1386449031
  Medicare reassignment NPD
• Kathleen Diehl LMSW LLC

  • Social Worker
  • Ann Arbor, MI
  • NPI 1841049632
  NPD (past)

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

{
    "created_epoch": "1275523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275523200000",
    "number": "1639499437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1945 PAULINE BLVD",
            "address_2": "STE. 10",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481035047",
            "telephone_number": "734-994-1531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1945 PAULINE BLVD",
            "address_2": "STE. 10",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481035047",
            "telephone_number": "734-994-1531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKBURN",
        "first_name": "KRISTIN",
        "middle_name": "R",
        "credential": "MSW, LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-03",
        "last_updated": "2010-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801067835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina Black
• Danielle Rose Black
• Devon Black
• Morgan Black
• Lisle Blackbourn
• Staci Christine Blackburn, MD
• Michael Blackstock, OT
• Meisha Lynne Blackwell, PHARMD
• Timothy S Blackwell, MD
• Karla Aurora Blackwood, MD

• Clinical Social Worker in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2010; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.