Active NPI
Derica Blackmon, LMSW
- Social Worker
- MC Gehee, AR
National Provider Identifier
1679439475
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 26359-M
- Practice address
- 307 W Poplar St
MC Gehee, AR 71654-2548 - Phone
- (870) 222-7314
- NPI assigned
- Dec 25, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 26359-M | AR | |
| Social Worker | 104100000X | 26359-M | AR | Primary |
Addresses
Primary practice location
307 W Poplar St
MC Gehee, AR 71654-2548
Mailing address
307 W Poplar St
MC Gehee, AR 71654-2548
Phone (870) 222-7314
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26359-M | AR | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1766620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1767484800000",
"number": "1679439475",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "307 W POPLAR ST",
"city": "MC GEHEE",
"state": "AR",
"postal_code": "716542548",
"telephone_number": "870-222-7314"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "307 W POPLAR ST",
"city": "MC GEHEE",
"state": "AR",
"postal_code": "716542548",
"telephone_number": "870-222-7314"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACKMON",
"first_name": "DERICA",
"credential": "LMSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-12-25",
"last_updated": "2026-01-04",
"certification_date": "2026-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "AR",
"license": "26359-M",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "AR",
"license": "26359-M",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in MC Gehee, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.