Active NPI
Bianca Blattman, LPC-A
- Mental Health Counselor
- Tyler, TX
National Provider Identifier
1699481358
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 90132
- Practice address
- 3310 S Broadway Ave Ste 212
Tyler, TX 75701-7818 - Phone
- (903) 201-7412
- NPI assigned
- Jan 26, 2023
- Last updated
- Jan 26, 2023
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 90132 | TX | Primary |
Addresses
Primary practice location
3310 S Broadway Ave Ste 212
Tyler, TX 75701-7818
Mailing address
3310 S Broadway Ave Ste 212
Tyler, TX 75701-7818
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Previously, effective Oct 8, 2024 through Oct 8, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 90132 | TX | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1674691200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1674691200000",
"number": "1699481358",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3310 S BROADWAY AVE STE 212",
"city": "TYLER",
"state": "TX",
"postal_code": "757017818"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3310 S BROADWAY AVE STE 212",
"city": "TYLER",
"state": "TX",
"postal_code": "757017818",
"telephone_number": "903-201-7412"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLATTMAN",
"first_name": "BIANCA",
"credential": "LPC-A",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-01-26",
"last_updated": "2023-01-26",
"certification_date": "2023-01-26",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "TX",
"license": "90132",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tyler, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.