KIMBERLY ANNE BLACKMON LPC NCC LCAS CCS NPI 1083747224

NPI Information

NPI: 1083747224
Provider Name: KIMBERLY ANNE BLACKMON, LPC, NCC, LCAS, CCS
Classification: Counselor - 101YA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

Address:
429 BILLINGSLEY RD
MECKLENBURG COUNTY AMH SASC
CHARLOTTE, NC
ZIP 28211
Phone: (704) 336-5651
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Kimberly Anne Blackmon, LPC, NCC, LCAS, CCS is an addiction (substance use disorder) counselor in Charlotte, NC. Kimberly Anne Blackmon, LPC, NCC, LCAS, CCS NPI is 1083747224. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

429 BILLINGSLEY RD
MECKLENBURG COUNTY AMH SASC
CHARLOTTE, NC
ZIP 28211-007
Phone: (704) 336-5651
Fax: (704) 336-5105

The enumeration date for this NPI number is 3/14/2007 and was last updated on 10/22/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	398	NORTH CAROLINA	Yes
2	101YP2500X	Counselor	Professional	3706S	NORTH CAROLINA	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	6102838	MEDICAID	NORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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