Fredric Darnell Blocker, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC007643 Issued in GA

Practice address

110 Habersham Dr
Ste 116
Fayetteville, GA 30214-1381

Phone

(770) 946-2312

NPI assigned

Sep 4, 2014

Last updated

Sep 4, 2014By the provider in NPPES

Sex

Male

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 GA

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

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.

• Heavenly Therapeutic Services LLC

  • Professional Counselor
  • Fayetteville, GA
  • NPI 1184025587
  Medicare reassignment NPD Authorized official
• Mental Health Specialty Group PA

  dba Rula Health

  • Mental Health Counselor
  • Durham, NC
  • NPI 1801472634

  GA, Professional

  Medicare reassignment NPD

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

{
    "created_epoch": "1409788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409788800000",
    "number": "1639570039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 HABERSHAM DR",
            "address_2": "STE 116",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302141381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 HABERSHAM DR",
            "address_2": "STE 116",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302141381",
            "telephone_number": "770-946-2312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOCKER",
        "first_name": "FREDRIC",
        "middle_name": "DARNELL",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-09-04",
        "last_updated": "2014-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC007643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samuel B Bleuez, MD
• Lehome' Bliss, PHD
• Latasha Latrice Blissett, LPC
• Sean Franklin Blithe, PT, DPT
• Ashlee Block, PA-C
• Tyra Blocker, RBT
• Blue Ocean Laboratory Services LLC
• Board of Commissioners of Fayette County (Fayette County EMS)
• Body in Balance Chiropractic & Wellness Center, LLC
• Body Revolution Healthcare Consultants

• Professional Counselor in Fayetteville, GA
• Providers in Fayetteville, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2014; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.