Jonathan D Blackwell, T-LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

03842 Issued in KS

Practice address

635 N Main St
Wichita, KS 67203-3602

Phone

(316) 660-7525

Fax

(316) 660-1897

NPI assigned

Jan 29, 2020

Last updated

Jul 7, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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": "1580256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625616000000",
    "number": "1942831862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "271 W 3RD ST N",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672021212",
            "telephone_number": "316-660-7600",
            "fax_number": "316-941-5075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 N MAIN ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672033602",
            "telephone_number": "316-660-7525",
            "fax_number": "316-660-1897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKWELL",
        "first_name": "JONATHAN",
        "middle_name": "D",
        "credential": "T-LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-29",
        "last_updated": "2021-07-07",
        "certification_date": "2021-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "KS",
            "license": "3551",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "KS",
            "license": "03842",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zachary Blackhurst, PHD
• Douglas K Blackman, OD
• Jacques D Blackman, MD
• Sheila Blackmon, RN
• Amanda J Blackmore, PA-C
• Meryiah Blaine, LMLP-T
• Anita S Blair, PSYD
• Bailey Ann Blair
• Grace Blair, LMSW
• Gerri Lee Blaisdell, LMSW

• Professional Counselor in Wichita, KS
• Providers in Wichita, KS by specialty
• Professional Counselor in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2021; 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.