Elizabeth Blackwood, MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

L11429 Issued in OR

Practice address

1005 SW Disk Dr Ste 104
Bend, OR 97702-3385

Phone

(541) 508-8906

NPI assigned

Aug 10, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1597017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734393600000",
    "number": "1780295287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63025 FREMONT RD",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977019677",
            "telephone_number": "541-508-8906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 SW DISK DR STE 104",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977023385",
            "telephone_number": "541-508-8906"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "63025 Fremont Rd",
            "address_purpose": "LOCATION",
            "city": "Bend",
            "state": "OR",
            "postal_code": "977019677",
            "country_code": "US",
            "telephone_number": "541-508-8906",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLACKWOOD",
        "first_name": "ELIZABETH",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-10",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L11429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor Jane Black
• Christopher Allen Blackburn, RN
• Whitney Blackham, LPC
• Jon Arthur Blackman, MD
• Jeffrey M Blackmon, M.D.
• Ryan Elizabeth Blackwood
• Gregory Paul Blair, M.D.
• Blake Drew DMD, PC
• Adriana Lynn Blake
• Donna Jean Blankenship

• Clinical Social Worker in Bend, OR
• Providers in Bend, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 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.

Verify at the official NPI Registry.