Kim Nelson-Blackburn, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34004056A Issued in IN

Practice address

1265 N Bradford Dr
Delphi, IN 46923-9553

Phone

(765) 564-2247

NPI assigned

Feb 23, 2011

Last updated

Feb 23, 2011By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Optum Behavioral Care of Colorado PCGroup PAC ID 0941648463, 196 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kim.nelson-blackburn.1@28621.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Optum Behavioral Care of Colorado, P.C.

  dba LifeSolutions Counseling Associates of Indiana

  • Clinical Psychologist
  • Carmel, IN
  • NPI 1497525828
  Medicare reassignment Care Compare group NPD
• Optum Behavioral Care of Colorado, P.C.

  • Clinical Social Worker
  • De Pere, WI
  • NPI 1396622494
  NPD
• Valley Oaks Health Inc

  • Federally Qualified Health Center (FQHC)
  • Lafayette, IN
  • NPI 1134901135
  NPD (past)
• Valley Oaks Health Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Lafayette, IN
  • NPI 1689629990
  NPD (past)

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

{
    "created_epoch": "1298419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298419200000",
    "number": "1811294168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1265 N BRADFORD DR",
            "city": "DELPHI",
            "state": "IN",
            "postal_code": "469239553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1265 N BRADFORD DR",
            "city": "DELPHI",
            "state": "IN",
            "postal_code": "469239553",
            "telephone_number": "765-564-2247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON-BLACKBURN",
        "first_name": "KIM",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-23",
        "last_updated": "2011-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34004056A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Milan, LSW
• Sara Miller
• Scott Alan Miller, O.D.
• Marilyn Minich
• Courtney Marie Murtaugh, LMHC
• Norman Eyecare LTD. (Norman & Miller EyeCare)
• Cameron Norman, OD
• Gregory D Norman, O. D.
• Angela K Norton, CHHP, CCMA, MLE
• Kimberly Renee O'Leary, MSW LCSW

• Clinical Social Worker in Delphi, IN
• Providers in Delphi, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2011; 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.

Verify at the official NPI Registry.