James Archie Blackwood, LSW
Individual provider Active NPI Social Worker · East Chicago, IN
NPI 1992848022 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1992848022
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- 33001367A (IN)
- Practice address
- 3903 Indianapolis Blvd
East Chicago, IN 46312-2555 - Phone
- (219) 398-7050
- Fax
- (219) 757-1950
- NPI assigned
- Feb 15, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 33001367A | IN | MD | Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 33001367A | IN | Yes |
Addresses
Primary practice location
3903 Indianapolis Blvd
East Chicago, IN 46312-2555
Mailing address
7716 Walnut Ave
Hammond, IN 46324-3236
Other providers in East Chicago, IN
- Robert Beedle
- Hanna-Elyzabeth Faith Bejar
- Cynthia R Bejster
- Alicia Berman
- Ladonna Berryhill
- Gregory Lee Blair
- Alfonso A Blum
- Addison M Boardman
- Deborah Kay Bona
- Lilia Ivette Bonilla
All providers in East Chicago, IN · Social Worker in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.