Melissa Blackman, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SC06289700 Issued in NJ

Practice address

5 Greentree Centre
525 Route 73
Marlton, NJ 08053

Phone

(609) 613-0110

NPI assigned

Feb 10, 2022

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

• Minnie Blackman Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1644451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718841600000",
    "number": "1861146565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 GREENTREE CTR",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080533422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 GREENTREE CENTRE",
            "address_2": "525 ROUTE 73",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "08053",
            "telephone_number": "609-613-0110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKMAN",
        "first_name": "MELISSA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-10",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC06289700",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SL06606600",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MINNIE",
            "last_name": "BLACKMAN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Rachelle Billiard, LCSW
• Brianna Bird, INHC
• Meghan E Bishop, M.D.
• Lisa D Blackburn, M.D.
• Jeffrey D Blackman, MD
• Anna Z Blair, OD
• Jennifer A Blair, OTR/L
• Tiffany Blake, MS, PHD
• Deborah Blastic
• Brian Vincent Blazovic, MD

• Clinical Social Worker in Marlton, NJ
• Providers in Marlton, NJ by specialty
• Clinical Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2024; 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.