Healthcare Provider Details

I. General information

NPI: 1982473948
Provider Name (Legal Business Name): MELISSA BLANKENSHIP CDCA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/01/2024
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 NOE BIXBY RD
COLUMBUS OH
43213-1460
US

IV. Provider business mailing address

35 N WASHINGTON ST
DELAWARE OH
43015-1915
US

V. Phone/Fax

Practice location:
  • Phone: 614-892-2454
  • Fax:
Mailing address:
  • Phone: 740-203-0026
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number184539
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: