Active NPI
Caitlin Blackwell
- Clinical Social Worker
- Newport News, VA
National Provider Identifier
1992217301
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 0904010029
- Practice address
- 729 Thimble Shoals Blvd Ste 7D
Newport News, VA 23606-4246 - Phone
- (913) 749-6653
- Fax
- (757) 599-1013
- NPI assigned
- Oct 26, 2017
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 0904010029 | VA | Primary |
Addresses
Primary practice location
729 Thimble Shoals Blvd Ste 7D
Newport News, VA 23606-4246
Mailing address
211 Broad St
Portsmouth, VA 23707-1601
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 |
|---|---|---|---|
| 0904010029 | VA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1508976000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1508976000000",
"number": "1992217301",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "211 BROAD ST",
"city": "PORTSMOUTH",
"state": "VA",
"postal_code": "237071601"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "729 THIMBLE SHOALS BLVD STE 7D",
"city": "NEWPORT NEWS",
"state": "VA",
"postal_code": "236064246",
"telephone_number": "913-749-6653",
"fax_number": "757-599-1013"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACKWELL",
"first_name": "CAITLIN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-10-26",
"last_updated": "2017-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "VA",
"license": "0904010029",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newport News, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.