MRS. GWENDOLYN MARCELLA BLACKNALL LGADC NPI 1275171217

NPI Information

NPI: 1275171217
Provider Name: MRS. GWENDOLYN MARCELLA BLACKNALL, LGADC
Classification: Counselor - 101YA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

Address:
65 DUKE ST STE 203
PRINCE FREDERICK, MD
ZIP 20678
Phone: (443) 824-4818
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MRS. Gwendolyn Marcella Blacknall, LGADC is an addiction (substance use disorder) counselor in Prince Frederick, MD. MRS. Gwendolyn Marcella Blacknall, LGADC NPI is 1275171217. 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:

65 DUKE ST STE 203
PRINCE FREDERICK, MD
ZIP 20678-128
Phone: (443) 824-4818

The enumeration date for this NPI number is 12/19/2019 and was last updated on 12/19/2019.

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)	LGA2466	MARYLAND	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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