Active NPI
Sara Ruth Blacklidge, PC
- Professional Counselor
- Centerville, OH
National Provider Identifier
1740622976
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- C.1200338
- Practice address
- 261 Regency Ridge Dr
Centerville, OH 45459-4221 - Phone
- (937) 410-3233
- NPI assigned
- Jul 30, 2013
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | C.1200338 | OH | Primary |
Addresses
Primary practice location
261 Regency Ridge Dr
Centerville, OH 45459-4221
Mailing address
261 Regency Ridge Dr
Centerville, OH 45459-4221
Phone (937) 410-3233
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C.1200338 | OH | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1375142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733788800000",
"number": "1740622976",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "261 REGENCY RIDGE DR",
"city": "CENTERVILLE",
"state": "OH",
"postal_code": "454594221",
"telephone_number": "937-410-3233"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "261 REGENCY RIDGE DR",
"city": "CENTERVILLE",
"state": "OH",
"postal_code": "454594221",
"telephone_number": "937-410-3233"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACKLIDGE",
"first_name": "SARA",
"middle_name": "RUTH",
"name_prefix": "Miss",
"credential": "PC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-07-30",
"last_updated": "2024-12-10",
"certification_date": "2024-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OH",
"license": "C.1200338",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Centerville, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.