Healthcare Provider Details

I. General information

NPI: 1326136284
Provider Name (Legal Business Name): CLAUDIA A BLACKBURN PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

524 FRONT STREET
LITITZ PA
17543-1708
US

IV. Provider business mailing address

711 SKYLINE DRIVE
LANCASTER PA
17601-4441
US

V. Phone/Fax

Practice location:
  • Phone: 717-299-7202
  • Fax: 717-627-3550
Mailing address:
  • Phone: 717-299-7202
  • Fax: 717-627-3550

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPS016125
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: