JUSTIN LEE BLACKWELL (NPI# 1871011486) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871011486 |
| Entity Type | Individual |
| Full Name | JUSTIN LEE BLACKWELL |
| Other Name | JUSTIN LEE ARRILDT |
| Credential | CSC-AD, MA-C, MHFA |
| Practice Address |
3501 University Blvd East Adelphi MD 20783 |
| Mailing Address |
305 Saint Michaels Cir Odenton MD 21113-2610 |
| Practice Telephone | 4106947202 |
| Practice Fax Number | 4106723250 |
| Mailing Telephone | 4106947202 |
| Mailing Fax Number | 4106723250 |
| Enumeration Date | 2017-09-04 |
| Last Update Date | 2020-06-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
SC2462 | MD | Behavioral Health & Social Service Providers |
| N | 175T00000X | Peer Specialist | PR0153 | MD | Other Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 7984 Willow Oak Lane, Pasadena, MD 21122 | (410) 694-1898 | 3012814012 |
| Street Address |
3501 UNIVERSITY BLVD EAST |
| City | ADELPHI |
| State | MD |
| Zip Code | 20783 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144862954 | Tera Duffer | Physician Assistant | 7506 Adelphi, Hyattsville, MD 20783 | 2019-10-14 |
| 1164999512 | Melorejuvenationsmeloweightloss LLC (dba) Best Pharmacy | Pharmacy | 6495 New Hampshire Av Suite # B130, Hyattsville, MD 20783 | 2018-10-24 |
| 1518446657 | Florentine Madeleine Domche - Pesok | Home Health Aide | 1836 Metzerott Rd Apt 1116, Adelphi, MD 20783 | 2018-08-09 |
| 1306365218 | Alain Samuel Kameni | Home Health Aide | 1906 Dana Dr., Hyattsville, MD 20783 | 2017-09-12 |
| 1154843712 | Annmarie Cynthia Wallace | Home Health Aide | 836 Fairoak Ave, Hyattsville, MD 20783 | 2017-07-14 |
| 1063934677 | Dorine Adeline Kouanang Lapa Epse Laakak | Technician | 4043 Greenlawn Drive Apt 100, Hyattsville, MD 20783 | 2017-07-14 |
| 1861914798 | Danielle Marie Graham | Social Worker | 1800 Metzerott Rd, Apt 206, Adelphi, MD 20783 | 2017-07-12 |
| 1336684703 | Evelin Reyes | Home Health Aide | 2121 Ruatan St, Hyattsville, MD 20783 | 2016-12-21 |
| 1689121238 | Carole Nkwignia Nketcha | Home Health Aide | 1908 Erie St Apt 102, Hyattsville, MD 20783 | 2016-09-01 |
| 1013363282 | Eshetue Muluneh | Home Health Aide | 6405 Elliott Pl, Hyattsivell, MD 20783 | 2016-05-06 |
| Find all providers in zip 20783 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366919037 | Jackson Wellness Group | Counselor | 1811 Metzerott Rd Apt 807, Adelphi, MD 20783-5192 | 2018-10-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861091522 | Choices Integrated Healthcare | Counselor | 1600 Bush St, Baltimore, MD 21230-2021 | 2020-10-22 |
| 1831706068 | James Simmons | Counselor | 975 Solomons Island Rd N # 119, Prince Frederick, MD 20678-3917 | 2020-10-01 |
| 1730791609 | Tony C Shaw | Counselor | 2814 W Garrison Ave, Baltimore, MD 21215-5335 | 2020-08-20 |
| 1134739600 | Crystal Yolanda Mason | Counselor | 10006 Antium Way, Owings Mills, MD 21117-4069 | 2020-08-08 |
| 1023628849 | Delores Jordan | Counselor | 2640 Oswego Ave, Baltimore, MD 21215-7037 | 2020-08-06 |
| 1588274773 | Positive Reinforcements Inc. | Counselor | 30260 Mount Vernon Rd Unit 6, Princess Anne, MD 21853-2202 | 2020-08-03 |
| 1073122511 | Rasheed Badmus | Counselor | 46 Solar Cir Apt A, Parkville, MD 21234-6831 | 2020-07-30 |
| 1144838277 | Guiding Lives | Counselor | 6305 Belair Rd, Baltimore, MD 21206-1817 | 2020-07-15 |
| 1750908943 | New Life Services LLC. | Counselor | 3600 W Mulberry St, Baltimore, MD 21229-2928 | 2020-07-03 |
| 1801413422 | Karena Tinika Lee | Counselor | 1336 Homestead St, Baltimore, MD 21218-3624 | 2020-06-30 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.