| Mary Beth R Blackwell Lcsw Llc | |
|
220 Arlington Way Ormond Beach FL 32176-8164 | |
| (913) 709-3209 | |
| Not Available |
| Full Name | Mary Beth R Blackwell Lcsw Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 220 Arlington Way, Ormond Beach, Florida |
| Authorized Official Name and Position | Mary Beth Blackwell (OWNER) |
| Authorized Official Contact | 9137093209 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mary Beth R Blackwell Lcsw Llc 220 Arlington Way Ormond Beach FL 32176-8164 Ph: (913) 709-3209 | Mary Beth R Blackwell Lcsw Llc 220 Arlington Way Ormond Beach FL 32176-8164 Ph: (913) 709-3209 |
| NPI Number | 1578395950 |
|---|---|
| Provider Enumeration Date | 08/15/2024 |
| Last Update Date | 11/06/2024 |
| Certification Date | 11/06/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578395950 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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