Wanda A Blackwell, MS, LPC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

LPC #3140 Issued in OK

Practice address

1131 N Kickapoo Ave
Shawnee, OK 74801-4845

Phone

(405) 275-2877

Fax

(405) 275-2877

NPI assigned

Nov 9, 2006

Last updated

Feb 9, 2010By 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

Enrolled in OK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Quest MhsaGroup PAC ID 4688943657, 19 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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.

• Quest Mhsa

  • Community/Behavioral Health Agency
  • Antlers, OK
  • NPI 1174776819
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265673600000",
    "number": "1740350396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3",
            "city": "MORRIS",
            "state": "OK",
            "postal_code": "744450003",
            "telephone_number": "918-733-9486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1131 N KICKAPOO AVE",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748014845",
            "telephone_number": "405-275-2877",
            "fax_number": "405-275-2877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKWELL",
        "first_name": "WANDA",
        "middle_name": "A",
        "credential": "MS, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-09",
        "last_updated": "2010-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OK",
            "license": "LPC #3140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wade Bittle, P.A.-C
• Richard Blackburn, LADC
• Morgan Blackstock, MS, RD/LD
• Davi Blackthorne
• Kalob Michael Blackwell, PA-C
• Latara Easton Blankenship
• Samantha Blankenship
• Kylie Makenzie Blas
• Hayden Blessing
• Emily Blythe

• Counselor in Shawnee, OK
• Providers in Shawnee, OK by specialty
• Counselor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.