Deborah Shogry Blalock

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

3225 Issued in SC

Practice address

2090 Executive Hall Rd Ste 170
Charleston, SC 29407-8710

Phone

(843) 852-3633

NPI assigned

Jan 22, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Deborah Shogry Dinovo Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• South Carolina Dept of Mental Health Accounting Office

  • Community/Behavioral Health Agency
  • Columbia, SC
  • NPI 1083421994
  NPD (past)

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211328000000",
    "number": "1669526547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2090 EXECUTIVE HALL RD STE 170",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294078710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2090 EXECUTIVE HALL RD STE 170",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294078710",
            "telephone_number": "843-852-3633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLALOCK",
        "first_name": "DEBORAH",
        "middle_name": "SHOGRY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-22",
        "last_updated": "2008-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "SC",
            "license": "3225",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1760596480",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "190166",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEBORAH",
            "last_name": "DINOVO",
            "middle_name": "SHOGRY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Julie Ane Blair, MA CCC-SLP
• Tracy Lynn Blair, CRNA
• Teresa Blake
• Deborah Denise Blakely, PAC
• Cynthia A Blalock, MD
• Elizabeth Adele Blalock, MD
• Marissa Blanco Knowlton, M.D.
• Jenna Delany Blandford, CRNA
• Jill Marie Blandford, D.O.
• Walker McRae Blanding, MD

• Professional Counselor in Charleston, SC
• Providers in Charleston, SC by specialty
• Professional Counselor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2008; 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.