Jill Blackwelder, LPCS, CCS, LCAS, NCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

2135 Issued in NC

Practice address

536 Signal Hill Drive Extension
Statesville, NC 28625

Phone

(704) 872-0234

Fax

(704) 818-1115

NPI assigned

Jan 8, 2007

Last updated

Jul 17, 2012By 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342483200000",
    "number": "1902954027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "536 SIGNAL HILL DRIVE EXT",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286254391",
            "telephone_number": "704-872-0234",
            "fax_number": "704-818-1115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "536 SIGNAL HILL DRIVE EXTENSION",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "28625",
            "telephone_number": "704-872-0234",
            "fax_number": "704-818-1115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKWELDER",
        "first_name": "JILL",
        "credential": "LPCS, CCS, LCAS, NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-08",
        "last_updated": "2012-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "2135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven Samuel Binder, DC
• Andrea M Binkley, FNP-C
• Rhoda Jane Black, RN
• Sarah Katherine Black, AUD
• William J Blackley, M.D.
• Pedro Ariel Blanco, DPT
• Blankenship Chiropractic Clinic, PA
• Radford H Blankenship, D.C.
• Nicole-Marie Blischak
• Stacey C Bohm, AGACNP-BC

• Mental Health Counselor in Statesville, NC
• Providers in Statesville, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 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.

Verify at the official NPI Registry.