Ophelia Marlene Blackwell, PHD, LCPC, LPC, NCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC011218 Issued in GA

Practice address

625 Nellie B Ave Ofc 1
Athens, GA 30601-3339

Phone

(888) 447-8231

NPI assigned

Sep 9, 2011

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

Other names 1

• Ophelia Marlene Baker Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Charity Faith & Hope Counseling Services LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Junction City, KS
  • NPI 1508340282

  Professional

  NPD Authorized official

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

{
    "created_epoch": "1315526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686528000000",
    "number": "1811279482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 NELLIE B AVE OFC 1",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306013339",
            "telephone_number": "704-315-0897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 NELLIE B AVE OFC 1",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306013339",
            "telephone_number": "888-447-8231"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "745 S Milledge Ave Ste 1A",
            "address_purpose": "LOCATION",
            "city": "Athens",
            "state": "GA",
            "postal_code": "306051292",
            "country_code": "US",
            "telephone_number": "770-389-8100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLACKWELL",
        "first_name": "OPHELIA",
        "middle_name": "MARLENE",
        "name_prefix": "Dr.",
        "credential": "PHD, LCPC, LPC, NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-09",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "KS",
            "license": "LCPC2305",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC011218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "OPHELIA",
            "last_name": "BAKER",
            "middle_name": "MARLENE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Michael S Biswas, MD
• Rachel Kay Black
• Daphne Lorraine Blackburn, M.D.
• Leasa Lasae Blackmon, RN
• Cydney Blackwell, PHARM D
• Daniel Blair, DO, FACP
• Diana T Blake, MD
• Rashay Blake, MSW
• Bryan Adam Blakeney, MD
• John C Blankenship

• Professional Counselor in Athens, GA
• Providers in Athens, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2023; 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.