Active NPI
Kurt C. Blackketter, LPC
- Professional Counselor
- Midland, TX
National Provider Identifier
1881944734
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 67378
- Practice address
- 2105 W Louisiana Ave
Midland, TX 79701-5919 - Phone
- (432) 550-5683
- NPI assigned
- Sep 18, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 67378 | TX | Primary |
Addresses
Primary practice location
2105 W Louisiana Ave
Midland, TX 79701-5919
Mailing address
2105 W Louisiana Ave
Midland, TX 79701-5919
Phone (432) 550-5683
Other names 1
- K.C. Blackketter
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 67378 | TX | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1347926400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1347926400000",
"number": "1881944734",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2105 W LOUISIANA AVE",
"city": "MIDLAND",
"state": "TX",
"postal_code": "797015919",
"telephone_number": "432-550-5683"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2105 W LOUISIANA AVE",
"city": "MIDLAND",
"state": "TX",
"postal_code": "797015919",
"telephone_number": "432-550-5683"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACKKETTER",
"first_name": "KURT",
"middle_name": "C.",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-09-18",
"last_updated": "2012-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "67378",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "K.C.",
"last_name": "BLACKKETTER",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Midland, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.