Michelle Dawn Blakeman, LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

S.1701354 Issued in OH

Practice address

4309 Highgate Rd
Fort Worth, TX 76244-5740

Phone

(146) 963-1220

NPI assigned

Sep 18, 2017

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

State licenses

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

{
    "created_epoch": "1505692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649808000000",
    "number": "1992224398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4309 HIGHGATE RD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762445740",
            "telephone_number": "146-963-1220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4309 HIGHGATE RD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762445740",
            "telephone_number": "146-963-1220"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Unit 33100",
            "address_purpose": "LOCATION",
            "city": "APO",
            "state": "AE",
            "postal_code": "091803100",
            "country_code": "US",
            "telephone_number": "318-590-6300",
            "country_name": "United States",
            "address_type": "MIL"
        }
    ],
    "basic": {
        "last_name": "BLAKEMAN",
        "first_name": "MICHELLE",
        "middle_name": "DAWN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-18",
        "last_updated": "2022-04-13",
        "certification_date": "2022-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.1701354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diane G Blaising, AU.D., FAAA, CCC-A
• David Tyler Blake
• Jennifer Christina Blake, MD
• Abby L Blakely, LCSW
• Margaret Lipham Blakely, MED, LPC
• Allison Blakewell, RN
• Charlie S. Blalock, CRNA
• Jake Blalock, MD
• Katherine Lindsey Blalock, ACNP
• Ashley Blanch, PHARMD

• Social Worker in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2022; 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.