Janet R. Blackham, PHD

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

3179 Issued in AZ

Practice address

1919 E Thomas Rd
BLDG. B
Phoenix, AZ 85016-7710

Phone

(602) 933-0414

Fax

(602) 933-0418

NPI assigned

Apr 5, 2006

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)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Phoenix Children'S Hospital Hope

  • Pharmacy
  • Phoenix, AZ
  • NPI 1386749836
  NPD (past)

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

{
    "created_epoch": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358208000000",
    "number": "1972565927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1919 E THOMAS RD",
            "address_2": "BLDG 2108, SUITE 101",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850167710",
            "telephone_number": "602-512-8029",
            "fax_number": "602-512-8161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 E THOMAS RD",
            "address_2": "BLDG. B",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850167710",
            "telephone_number": "602-933-0414",
            "fax_number": "602-933-0418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKHAM",
        "first_name": "JANET",
        "middle_name": "R.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-05",
        "last_updated": "2013-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "AZ",
            "license": "3179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margaret A Black
• Natalie Black, MOT
• Sheri L Black, RN,BSN
• Abigail Hedy Blackburn Green
• Paul A. Blackburn, DO
• D'Angelo Garrett Blackhorse, DMD
• Jill Ryann Blackman
• Russell Scott Blackman, D.D.S.
• Courtney Cathryn Blackmer, MSW
• Kiajera Oshanay Blackston, DACCHM

• Clinical Child & Adolescent Psychologist in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Clinical Child & Adolescent Psychologist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2013; 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.