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NPI Code Detail

MEDICARE: LORI DAWN BLACKMAN L.C.S.W.

MEDICARE: LORI DAWN BLACKMAN L.C.S.W.
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 Worker.13898SC
21041C0700XClinical Social WorkerLCS 24722CA
31041C0700XClinical Social WorkerSW 7330FL

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 : 1750403127
Entity Type Code : Individual
Provider Name (Legal Business Name) : LORI DAWN BLACKMAN L.C.S.W.
Provider Business Mailing Address
First Line : 406 PARKER IVEY DR
Second Line :
City : GREENVILLE
State : SC
Zip : 29607-6513
Country : US
Telephone Number : 561-602-4114
Fax Number : 561-455-9988
Provider Business Practice Location Address
First Line : 1615 S CONGRESS AVE STE 103
Second Line :
City : DELRAY BEACH
State : FL
Zip : 33445-6326
Country : US
Telephone Number : 561-917-9997
Fax Number : 561-455-9988
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/04/2007
Last Update Date : 06/02/2025

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