Guy Blackstone, LPC, CRC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

4546-226 Issued in WI

Practice address

2961 Yarmouth Greenway Dr Ste 2
Fitchburg, WI 53711-5809

Phone

(608) 504-3600

Fax

(608) 504-3700

NPI assigned

Dec 18, 2019

Last updated

Jun 22, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Guy Smith Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Blackstone Therapy, LLC

  • Mental Health Counselor
  • Fitchburg, WI
  • NPI 1205562030
  NPD Authorized official

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

{
    "created_epoch": "1576627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655856000000",
    "number": "1700424850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4351 DONCASTER DR",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537113717",
            "telephone_number": "181-598-1263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2961 YARMOUTH GREENWAY DR STE 2",
            "city": "FITCHBURG",
            "state": "WI",
            "postal_code": "537115809",
            "telephone_number": "608-504-3600",
            "fax_number": "608-504-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKSTONE",
        "first_name": "GUY",
        "credential": "LPC, CRC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-12-18",
        "last_updated": "2022-06-22",
        "certification_date": "2022-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WI",
            "license": "4546-226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GUY",
            "last_name": "SMITH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kenneth Paul Bichell, RN
• Bio-Medical Applications of Wisconsin, Inc. (Fresenius Medical Care Madison Capitol)
• Birch Tree Mental Health Services
• Lynn Blackbourn, LPC
• Blackstone Therapy, LLC
• Tracy Fey Blackstone, MS, CRC, LPC, ASDCS
• Natalie M Blonien, PT
• Blue Star Transit LLC (premier Care llc)
• Blue Star Transit LLC
• Lauren M Blume, MS, CCC-SLP

• Counselor in Fitchburg, WI
• Providers in Fitchburg, WI by specialty
• Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2022; 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.