MRS. TRACY BLACKMON (NPI# 1942515846) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942515846 |
| Entity Type | Individual |
| Full Name | MRS. TRACY BLACKMON |
| Other Name | MRS. TRACY BLACKMON |
| Credential | MSW, LCSW, LCAS |
| Practice Address |
1706 Wayne Memorial Dr Goldsboro NC 27534-2240 |
| Mailing Address |
305 Jacobs Ridge Dr Goldsboro NC 27534-8691 |
| Practice Telephone | 9197346676 |
| Mailing Telephone | 9197781552 |
| Enumeration Date | 2010-08-16 |
| Last Update Date | 2013-02-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1041C0700X |
Social Worker Specialization: Clinical |
1823 | NC | Behavioral Health & Social Service Providers |
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
C007924 | NC | Behavioral Health & Social Service Providers |
| Street Address |
1706 WAYNE MEMORIAL DR |
| City | GOLDSBORO |
| State | NC |
| Zip Code | 27534-2240 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316988959 | James T. Smith | Psychologist | 1706 Wayne Memorial Dr, Goldsboro, NC 27534-2240 | 2006-06-08 |
| 1487267902 | Kenneth Freeman | Counselor | 1706 Wayne Memorial Dr, Goldsboro, NC 27534-2240 | 2020-08-25 |
| 1316564370 | Latisha B Cowan | Counselor | 1706 Wayne Memorial Dr, Goldsboro, NC 27534-2240 | 2020-06-25 |
| 1629693981 | Alyse B Deselms | Counselor | 1706 Wayne Memorial Dr, Goldsboro, NC 27534-2240 | 2020-06-12 |
| 1669000279 | Dori Oxendine Akasson | Social Worker | 1706 Wayne Memorial Dr, Goldsboro, NC 27534-2240 | 2020-03-30 |
| 1316586456 | Candra Nikita Edwards | Social Worker | 1706 Wayne Memorial Dr, Goldsboro, NC 27534-2240 | 2020-01-06 |
| 1962049106 | Forrest Cody Robinson | Counselor | 1706 Wayne Memorial Dr, Goldsboro, NC 27534-2240 | 2019-12-06 |
| 1215588173 | Andie Lorin Strickland | Counselor | 1706 Wayne Memorial Dr, Goldsboro, NC 27534-2240 | 2019-09-23 |
| 1972096451 | Jimmy Ballard Harrell | Psychologist | 1706 Wayne Memorial Dr, Goldsboro, NC 27534-2240 | 2018-06-11 |
| 1467942904 | Halle J Clark | Counselor | 1706 Wayne Memorial Dr, Goldsboro, NC 27534-2240 | 2018-05-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457875767 | Trent Jonathan Forshey | Physical Therapist | 2126 Wayne Memorial Dr, Goldsboro, NC 27534 | 2017-07-28 |
| 1336685551 | Wayne Al Holdings, LLC | Assisted Living Facility | 901 West New Hope Rd, Goldsboro, NC 27534 | 2017-01-11 |
| 1952845471 | Latoya Faulk | Social Worker | 121 Carolina Forest Drive, Goldsboro, NC 27534 | 2016-12-19 |
| 1528415841 | Kelby Joseph Sage Durnin | Military Health Care Provider | 1020 Jabara Avenue, Seymour Johnson Afb, NC 27534 | 2016-05-17 |
| 1528490604 | Eric Christian Bourgeois | Physical Therapist | 1101a Gracie Pl, Goldsboro, NC 27534 | 2013-07-31 |
| 1831439165 | Erica Nicole Davis | Optometrist | 20/20 Vision Center 625 North Berkeley Blvd, Suite D, Goldsboro, NC 27534 | 2013-02-23 |
| 1891039236 | Betty Webb Zimmerman | Nurse Practitioner | 204 Cox Blvd, Goldsboro, NC 27534 | 2012-11-26 |
| 1144595265 | Life Recovery Psychological Services | Counselor | 1202-c Wayne Memorial Dr, Goldsboro, NC 27534 | 2012-03-22 |
| 1558596536 | Taylor Home | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 802 Taylor St, Goldsboro, NC 27534 | 2009-05-20 |
| 1780895136 | Sherrie Fennell Edwards | Dietitian, Registered | 1500 Lanely Ave., Seymour Johnson Afb, Golsboro, NC 27534 | 2007-05-25 |
| Find all providers in zip 27534 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669017810 | Elvira Carreno | Social Worker | 696 N Spence Ave Ste A, Goldsboro, NC 27534-4354 | 2019-11-12 |
| 1639676117 | Tasha S Hunter | Social Worker | 407 Wingspread Dr, Goldsboro, NC 27530-9625 | 2018-04-10 |
| 1952845471 | Latoya Faulk | Social Worker | 121 Carolina Forest Drive, Goldsboro, NC 27534 | 2016-12-19 |
| 1194150136 | Courtenay Hall | Social Worker | 1101 S Andrews Ave, Goldsboro, NC 27530-6622 | 2013-09-10 |
| 1649515024 | Laura Beth Barton | Social Worker | 2400 Wayne Memorial Dr Ste I, Goldsboro, NC 27534-1749 | 2012-12-11 |
| 1376896274 | Sharon G Jeanes | Social Worker | 307 E Beech Street, Goldsboro, NC 27530-2818 | 2012-10-17 |
| 1912254269 | Easter Mae Lewis | Social Worker | 109 Wintergreen Pl, Goldsboro, NC 27534-8036 | 2012-08-06 |
| 1962795112 | Charmaine Reenada Dees | Social Worker | 2719 Graves Dr Ste 5, Goldsboro, NC 27534-4536 | 2011-05-20 |
| 1467789776 | Tommel Hayes | Social Worker | 1706 Waynesboro Family Clinic, Goldsboro, NC 27534-2240 | 2009-11-06 |
| 1194997379 | Tranquility Counseling Services | Social Worker | 3300 Cashwell Dr, Suite # 3, Goldsboro, NC 27534-4456 | 2008-03-28 |
| Find all providers in GOLDSBORO | ||||
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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.