Heather Anne Blackmore, LMFTA
Individual provider Active NPI Counselor · Port Townsend, WA
NPI 1770140980 · NPPES record last updated Oct 4, 2021
Key facts
- NPI
- 1770140980
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- License
- MC60354376 (WA)
- Practice address
- 884 W Park Ave
Port Townsend, WA 98368-2273 - Phone
- (360) 385-0321
- NPI assigned
- May 22, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MC60354376 | WA | MD | Counselor |
| MG60354376 | WA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jefferson Community Counseling Center | Current |
Accepting new patients | |
| Madrona Institute of Washington | Past |
Accepting new patients |
Locations
884 W Park Ave
Port Townsend, WA 98368
Phone 3603850321201
Interoperability endpoints
- https://api.qualifacts.org/api/fhir/discoverybh/r4/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | MG60354376 | WA | |
| Counselor | 101Y00000X | MC60354376 | WA | Yes |
Addresses
Primary practice location
884 W Park Ave
Port Townsend, WA 98368-2273
Mailing address
PO Box 565
Port Townsend, WA 98368-0565
Phone (360) 385-0321
Other providers in Port Townsend, WA
- Lesta A Bentley
- Vitaliy Berezhnoy
- Matthew Patrick Berryman
- Katherine Biccum
- Rachel Lynn Bickling
- Trenatty E. Blackwell
- James Clayton Blair III
- Katrina Blair
- Patricia Ann Bolen
- Susan F Bone O'Brien
All providers in Port Townsend, WA · Counselor in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 4, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.