BRYSON DALE BLACKBURN LCSW NPI 1891208393

NPI Information

NPI: 1891208393
Provider Name: BRYSON DALE BLACKBURN, LCSW
Classification: Counselor - 101YM0800X
Entity Type: Individual

Specialization: Mental Health

PECOS Registration: Yes

Address:
725 N 12TH AVE
ARCADIA, FL
ZIP 34266
Phone: (863) 494-1242
Get Directions

Bryson Dale Blackburn, LCSW is a mental health counselor in Arcadia, FL. Bryson Dale Blackburn, LCSW NPI is 1891208393. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

725 N 12TH AVE
ARCADIA, FL
ZIP 34266-752
Phone: (863) 494-1242
Fax: (863) 491-0466

The NPI 1891208393 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 11/7/2017 and was last updated on 7/21/2023.

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	1041C0700X	Social Worker	Clinical	SW14904	FLORIDA	No
2	101YM0800X	Counselor	Mental Health	SW14904	FLORIDA	Yes

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: 4/28/2024

NPI Synchronization or Removal

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