Michael A. Blacet, LCSW-P

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

4693-P Issued in OK

Practice address

4930 S Sheridan Rd
Tulsa, OK 74145-5712

Phone

(918) 392-4008

Fax

(918) 392-4009

NPI assigned

Mar 1, 2013

Sex

Male

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 OK

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, 2009

Medicare assignment

May accept Medicare assignment

Group practices

Chris King Counseling Services LLCGroup PAC ID 8022385574, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Chris King Counseling Services LLC

  • Professional Counselor
  • Tulsa, OK
  • NPI 1669872131

  OK

  Medicare reassignment Care Compare group NPD
• Christian Counseling Center of Tulsa

  • Marriage & Family Therapist
  • Tulsa, OK
  • NPI 1538383161
  NPD (past)

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

{
    "created_epoch": "1362096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381276800000",
    "number": "1831439751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2005 W TOLEDO PL",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740125136",
            "telephone_number": "918-815-5425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4930 S SHERIDAN RD",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741455712",
            "telephone_number": "918-392-4008",
            "fax_number": "918-392-4009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACET",
        "first_name": "MICHAEL",
        "middle_name": "A.",
        "name_prefix": "Mr.",
        "credential": "LCSW-P",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-01",
        "last_updated": "2013-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OK",
            "license": "4693-P",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joan Bjornsgaard, LPC
• Suzanne Stella Bjornson, APRN
• Tara Nichole Bjornson
• Victoria Wilhelm Bjornson, DO
• Daeva Blacc
• Black Hawk Labs LLC
• Alyssa Crews Black, PA
• Hollie Lynn Black, D.O.
• Jamica L Black
• Jeffrey Lane Black

• All providers in Tulsa, OK
• Clinical Social Worker in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2013; 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.