Jeannine Blackwell, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW 13385 Issued in FL

Practice address

14527 7TH St
Dade City, FL 33523-3102

Phone

(352) 345-1235

NPI assigned

Mar 25, 2016

Last updated

Mar 25, 2016By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1458864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458864000000",
    "number": "1699137950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27221 STATE ROAD 56 # 139",
            "city": "WESLEY CHAPEL",
            "state": "FL",
            "postal_code": "335448832",
            "telephone_number": "352-345-1235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14527 7TH ST",
            "city": "DADE CITY",
            "state": "FL",
            "postal_code": "335233102",
            "telephone_number": "352-345-1235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKWELL",
        "first_name": "JEANNINE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-25",
        "last_updated": "2016-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW 13385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Meghan Bisson
• Coral Lynn Blake, MSCP
• Daddy Nimoh Boateng, PHARMD
• Robert H. Booker, AP/DOM
• Alyssa F Bordoni, RBT
• Gladys Borges, M.S., LD/N

• Clinical Social Worker in Dade City, FL
• Providers in Dade City, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2016; 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.