Active NPI
Caleb Blackman, LGSW
- Social Worker
- Decatur, AL
National Provider Identifier
1770903197
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 3311G
- Practice address
- 1315 13TH Ave SE
Decatur, AL 35601-4308 - Phone
- (256) 260-7361
- Fax
- (256) 260-7341
- NPI assigned
- Apr 24, 2014
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 3311G | AL | Primary |
Addresses
Primary practice location
1315 13TH Ave SE
Decatur, AL 35601-4308
Mailing address
1316 Somerville Rd SE
Suite 1
Decatur, AL 35601-4305
Phone (256) 260-7361
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 51148833 | Other | AL | BLUE CROSS BLUE SHIELD OF AL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
16 E Moulton St
Decatur, AL 35601-2301
Phone (256) 822-2375
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3311G | AL | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Covenant Counseling & Consulting LLC | Current | Accepting new patients | |
| Mental Health Center of North Central Alabama Inc. | Past | Accepting new patients |
Locations
14790 Brownsferry Rd
Athens, AL 35611
Phone (256) 822-2375
251 Johnston St SE
Ste 100
Decatur, AL 35601
Phone (256) 822-2375
16 Moulton St E
Decatur, AL 35601
Phone (256) 822-2375
1634 Slaughter Rd
Ste C
Madison, AL 35758
Phone (256) 822-2375
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Professional Counselor
- Decatur, AL
- NPI 1295111557
-
- Community/Behavioral Health Agency
- Decatur, AL
- NPI 1124193636
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1398297600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1405555200000",
"number": "1770903197",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1316 SOMERVILLE RD SE",
"address_2": "SUITE 1",
"city": "DECATUR",
"state": "AL",
"postal_code": "356014305",
"telephone_number": "256-260-7361",
"fax_number": "256-341-0747"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1315 13TH AVE SE",
"city": "DECATUR",
"state": "AL",
"postal_code": "356014308",
"telephone_number": "256-260-7361",
"fax_number": "256-260-7341"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACKMAN",
"first_name": "CALEB",
"credential": "LGSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-04-24",
"last_updated": "2014-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "AL",
"license": "3311G",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD OF AL",
"identifier": "51148833",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Decatur, AL
- Margaret Sue Bishop, MS
- Paul Harvey Bishop, D.M.D
- Bizzy Beez Enterprises LLC (MediRide Express)
- BKD Personal Assistance Services LLC (Brookdale at Home Cedar Springs)
- Barry G. Black, CRNA
- Candice Nicole Blackwood, FNP
- Paige Blackwood, RN
- Kaitlyn Blagburn, BA
- Logan Chandler Blake, PT, DPT
- Morgan Taylor Blake, PT, DPT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2014; 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.