Rebecca Blackwell, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

2011007859 Issued in MO

Practice address

1333 West Lockwood
Saint Louis, MO 63122-4817

Phone

(800) 780-6545

Fax

(888) 507-4453

NPI assigned

Aug 9, 2012

Last updated

Aug 9, 2012By 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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Blackwell & Roscoe Autism Spectrum Intervention Partners, Inc.

  • Behavior Analyst
  • Saint Louis, MO
  • NPI 1215261045
  NPD (past) Authorized official
• Judevine, Inc.

  dba Judevine Center for Autism

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Saint Louis, MO
  • NPI 1518291418
  Authorized official Same address or phone

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

{
    "created_epoch": "1344470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344470400000",
    "number": "1689921504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 HOLLY DRIVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631194639",
            "telephone_number": "314-749-7768",
            "fax_number": "888-507-4453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1333 WEST LOCKWOOD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631224817",
            "telephone_number": "800-780-6545",
            "fax_number": "888-507-4453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKWELL",
        "first_name": "REBECCA",
        "name_prefix": "Ms.",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-09",
        "last_updated": "2012-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MO",
            "license": "2011007859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anita Jane Blackwell, RNCPNP
• Danielle Carmen Blackwell, ACNP
• Deborah A Blackwell, MSN, RN, FNP-C
• Gillian Blackwell, ANP
• Mary Wallace Blackwell, EDS, MED, BSED
• Jennalie Evelyn Blackwood, PHARM.D.
• Sara K Blackwood
• Lindsey Blaha, PA-C
• Lydia Lucille Blaies, DPT
• Susan W Blain, PSY D

• Behavior Analyst in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Behavior Analyst in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2012; 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.