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NPI Code Detail

MEDICARE: CAROL J BLANKENSHIP LCSQ

MEDICARE:   CAROL J BLANKENSHIP  LCSQ
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerLCSW2974AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1598746323
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAROL J BLANKENSHIP LCSQ
Provider Business Mailing Address
First Line : 1775 E SKYLINE DR
Second Line : STE 101
City : TUCSON
State : AZ
Zip : 85718-1162
Country : US
Telephone Number : 520-615-6200
Fax Number : 520-615-6255
Provider Business Practice Location Address
First Line : 1775 E SKYLINE DR
Second Line : STE 101
City : TUCSON
State : AZ
Zip : 85718-1162
Country : US
Telephone Number : 520-615-6200
Fax Number : 520-615-6255
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/09/2005
Last Update Date : 07/08/2007

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Directions to “ CAROL J BLANKENSHIP LCSQ” Practice Location

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