MRS. LATREASA DENISE BLACKMON LPC NPI 1063179547

NPI Information

  • NPI: 1063179547
  • Provider Name: MRS. LATREASA DENISE BLACKMON, LPC
  • Classification: Counselor - 101Y00000X
  • Entity Type: Individual
  • Address: 500 E OGDEN AVE STE 101
    NAPERVILLE, IL
    ZIP 60563
  • Phone: (331) 444-2342

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NPI Details

MRS. Latreasa Denise Blackmon, LPC is a counselor in Naperville, IL. The provider is a provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification. MRS. Latreasa Denise Blackmon, LPC NPI is 1063179547. 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:

500 E OGDEN AVE STE 101
NAPERVILLE, IL
ZIP 60563-264
Phone: (331) 444-2342

The enumeration date for this NPI number is 11/19/2021 and was last updated on 11/19/2021.

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
1101Y00000XCounselor178017570ILLINOISYes

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: 3/30/2025

NPI Synchronization or Removal

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