Individual provider Active NPI

Stephen Harold Blackmore, PH.D.

  • Counseling Psychologist
  • Houston, TX
National Provider Identifier
1720164643
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
22841 Issued in TX
Practice address
15840 FM 529 Rd
Suite 210-B
Houston, TX 77095-2504
Phone
(281) 345-9464
Fax
(281) 345-9464
NPI assigned
Oct 31, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X 22841 TX Primary

Addresses

Primary practice location

15840 FM 529 Rd
Suite 210-B
Houston, TX 77095-2504

Mailing address

15840 FM 529 Rd
Suite 210-B
Houston, TX 77095-2504
Phone (281) 345-9464

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
22841TXMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720164643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15840 FM 529 RD",
            "address_2": "SUITE 210-B",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770952504",
            "telephone_number": "281-345-9464",
            "fax_number": "281-345-9464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15840 FM 529 RD",
            "address_2": "SUITE 210-B",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770952504",
            "telephone_number": "281-345-9464",
            "fax_number": "281-345-9464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKMORE",
        "first_name": "STEPHEN",
        "middle_name": "HAROLD",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "TX",
            "license": "22841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.