Active NPI
Karen Blackbird, LCSW
- Clinical Social Worker
- Butte, MT
National Provider Identifier
1689978017
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 951
- Practice address
- 55 Basin Creek Rd
Butte, MT 59701-9074 - Phone
- (406) 496-6314
- Fax
- (406) 494-1724
- NPI assigned
- Dec 28, 2010
- Last updated
- Dec 28, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 951 | MT | Primary |
Addresses
Primary practice location
55 Basin Creek Rd
Butte, MT 59701-9074
Mailing address
PO Box 382
East Glacier, MT 59434-0382
Phone (406) 338-2725
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477745370 | Medicaid | MT |
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 |
|---|---|---|---|
| 951 | MT | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Resilient Health, Inc. | Past | Accepting new patients | |
| Resilient Health, Inc. | Past | Accepting new patients |
Organizations & group practices 2
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.
-
dba Resilient Health
- Community/Behavioral Health Agency
- Gilbert, AZ
- NPI 1053102681
-
dba Resilient Health
- Community/Behavioral Health Agency
- Gilbert, AZ
- NPI 1366094930
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1293494400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1293494400000",
"number": "1689978017",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 382",
"city": "EAST GLACIER",
"state": "MT",
"postal_code": "594340382",
"telephone_number": "406-338-2725"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "55 BASIN CREEK RD",
"city": "BUTTE",
"state": "MT",
"postal_code": "597019074",
"telephone_number": "406-496-6314",
"fax_number": "406-494-1724"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACKBIRD",
"first_name": "KAREN",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-12-28",
"last_updated": "2010-12-28",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MT",
"license": "951",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1477745370",
"state": "MT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Butte, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.