Bathsheva Blackston, MFT-INTERN

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

IMT4162 Issued in FL

Practice address

2419 Hollywood Blvd
Hollywood, FL 33020-6605

Phone

(954) 361-4535

NPI assigned

Nov 27, 2024

Sex

Female

Sole proprietor

Yes

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1732665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732665600000",
    "number": "1992521678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5051 N 37TH ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330212242",
            "telephone_number": "213-709-7001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2419 HOLLYWOOD BLVD",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330206605",
            "telephone_number": "954-361-4535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKSTON",
        "first_name": "BATHSHEVA",
        "credential": "MFT-INTERN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-11-27",
        "last_updated": "2024-11-27",
        "certification_date": "2024-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "IMT4162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Beda Bjorn
• BL Community Services Corp.
• Rachel Blachman
• Starasia Black
• Kelvinesha Blackshear
• Blade Reliant
• Dahlia Ann Blake, MD
• Nadege M Blanc, APRN
• Maydibis Blanco Alonso
• Raul Blanco Azcuy, MD

• Marriage & Family Therapist in Hollywood, FL
• Providers in Hollywood, FL by specialty
• Marriage & Family Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2024; 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.