David Blackburn, LCSW-C

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

04114 Issued in MD

Practice address

939 Elkridge Landing Rd Ste 350
Linthicum, MD 21090-2909

Phone

(443) 354-8903

Fax

(443) 410-0663

NPI assigned

Mar 20, 2007

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636675200000",
    "number": "1922123702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "939 ELKRIDGE LANDING RD STE 350",
            "city": "LINTHICUM",
            "state": "MD",
            "postal_code": "210902909",
            "telephone_number": "443-354-8903",
            "fax_number": "443-410-0643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "939 ELKRIDGE LANDING RD STE 350",
            "city": "LINTHICUM",
            "state": "MD",
            "postal_code": "210902909",
            "telephone_number": "443-354-8903",
            "fax_number": "443-410-0663"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6355 Woodside Ct",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "MD",
            "postal_code": "210461071",
            "country_code": "US",
            "telephone_number": "410-381-7171",
            "fax_number": "410-381-5137",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLACKBURN",
        "first_name": "DAVID",
        "credential": "LCSW-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-20",
        "last_updated": "2021-11-12",
        "certification_date": "2021-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "04114",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "135781600",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashleigh Barron, DPT
• Frederica H Barrow, PH.D., LICSW, LCSW-C
• Logan Beal, PSYCHOLOGY ASSOCIATE
• Megan Nicole Benner, CPNP
• Nicole S Berger, PSYD
• Block Vision, Inc
• Simone Bloom
• Samuel Bolin Jr., LCSW-C
• Bridgeway Behavioral Health
• Genee Ashley Brome, RN

• Clinical Social Worker in Linthicum, MD
• Providers in Linthicum, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.