Alexis Blackmon, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

MSW010705 Issued in GA

Practice address

1444 Fenwick Dr SW
Marietta, GA 30064-2779

Phone

(678) 561-3868

NPI assigned

Mar 29, 2023

Last updated

May 9, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Healed Grace Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Charnat LLC

  dba Turning Point Counseling Centers

  • Community/Behavioral Health Agency
  • Marietta, GA
  • NPI 1154995629

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1680048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683590400000",
    "number": "1831893106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4405 MALL BLVD",
            "city": "UNION CITY",
            "state": "GA",
            "postal_code": "302912044",
            "telephone_number": "000-000-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1444 FENWICK DR SW",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300642779",
            "telephone_number": "678-561-3868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKMON",
        "first_name": "ALEXIS",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-29",
        "last_updated": "2023-05-09",
        "certification_date": "2023-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "GA",
            "license": "MSW010705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEALED",
            "last_name": "GRACE",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Ashley Kate Spencer Bissenas, MD
• Atanu Biswas, MD
• Alicia Bittle
• Laurie Eileen Bivins, RN, MSN, CPNP
• Nicole Black, PA-C
• Joshua D Blackmon, M.ED.,CCC
• Sarah Turner Blackstock, AGACNP-BC
• Blackstone Health Services LLC
• Earlean Blackwell
• Lynn Parker Blackwell, RN

• Social Worker in Marietta, GA
• Providers in Marietta, GA by specialty
• Social Worker in Georgia

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