MR. SAMUEL AUSTIN BLACKWODD CAS. A/A NPI 1568649937

NPI Information

NPI: 1568649937
Provider Name: MR. SAMUEL AUSTIN BLACKWODD, CAS., A/A
Classification: Counselor - 101YA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

Address:
25772 MARTIN LUTHER KING BLVD.
FRESNO, CA
ZIP 93706
Phone: (559) 265-5983
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MR. Samuel Austin Blackwodd, CAS., A/A is an addiction (substance use disorder) counselor in Fresno, CA. MR. Samuel Austin Blackwodd, CAS., A/A NPI is 1568649937. 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:

25772 MARTIN LUTHER KING BLVD.
FRESNO, CA
ZIP 93706
Phone: (559) 265-5983
Fax: (559) 455-5983

The enumeration date for this NPI number is 1/28/2008 and was last updated on 1/28/2008.

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)			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: 11/14/2023

NPI Synchronization or Removal

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