David E Blackwelder, PH. D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

1963 Issued in WI

Practice address

2020 W Wells St
Milwaukee, WI 53233-2720

Phone

(414) 937-2020

NPI assigned

Jul 25, 2008

Sex

Male

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 25, 2008.

{
    "created_epoch": "1216944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216944000000",
    "number": "1780849067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3715 STONEBROOK CT",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530052266",
            "telephone_number": "262-783-6708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 W WELLS ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532332720",
            "telephone_number": "414-937-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKWELDER",
        "first_name": "DAVID",
        "middle_name": "E",
        "name_prefix": "Mr.",
        "credential": "PH. D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-25",
        "last_updated": "2008-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WI",
            "license": "1963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Valerie Black, PA-C
• Lynn A. Blackburn, PH.D.
• Kymberlee A Blackford
• Brittney Blackmon
• Tiffany Antoinette Blackmon, APSW
• Katherine Elizabeth Blackwell
• Blackwell, LLC
• Lisa Marie Blaeser, LCSW
• Irina A Blagoeva, NP
• Adam Blaha

• All providers in Milwaukee, WI
• Clinical Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2008; 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.