| Blackburn Social Services Pllc | |
|
1029 W Crawford St Denison TX 75020-4329 | |
| (903) 462-4600 | |
| (903) 298-0046 |
| Full Name | Blackburn Social Services Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 1029 W Crawford St, Denison, Texas |
| Authorized Official Name and Position | Anthony Paul Blackburn (OWNER/MANAGER) |
| Authorized Official Contact | 9034624600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Blackburn Social Services Pllc 1029 W Crawford St Denison TX 75020-4329 Ph: (903) 462-4600 | Blackburn Social Services Pllc 1029 W Crawford St Denison TX 75020-4329 Ph: (903) 462-4600 |
| NPI Number | 1629456173 |
|---|---|
| Provider Enumeration Date | 05/15/2015 |
| Last Update Date | 05/15/2015 |
| Medicare PECOS PAC ID | 3678884707 |
|---|---|
| Medicare Enrollment ID | O20150616002360 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629456173 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | 56023 (Texas) | Primary |
| Provider Name | Anthony P Blackburn |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568840015 PECOS PAC ID: 8820309958 Enrollment ID: I20150616002680 |
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