Diana D Blandon, MSW,QMHP

Primary specialty

Social WorkerTaxonomy code 104100000X

License

0906011240 Issued in VA

Practice address

4000 Genesee PL Ste 101
Woodbridge, VA 22192-8302

Phone

(571) 659-0056

NPI assigned

Jun 30, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1625011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625011200000",
    "number": "1659941755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1616 KENTUCKY AVE",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221913658",
            "telephone_number": "540-303-1217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 GENESEE PL STE 101",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221928302",
            "telephone_number": "571-659-0056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANDON",
        "first_name": "DIANA",
        "middle_name": "D",
        "credential": "MSW,QMHP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-30",
        "last_updated": "2021-06-30",
        "certification_date": "2021-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "VA",
            "license": "0733003450",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0906011240",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "VA",
            "license": "0906011240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bruce Ellis Black II
• Jerrold G Black, MD
• Eric Blackstone, DPT
• Debbie June Blackwell
• Kristy A Blair, D.P.T
• Blessed Healthcare Professionals, Inc
• Blessed Support Professionals, Inc
• Blessfull Homecare LLC
• Blissful Years Group Home LLC
• Blooming Ride Inc

• Social Worker in Woodbridge, VA
• Providers in Woodbridge, VA by specialty
• Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2021; 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.