JACOB BLACKWELL (NPI# 1871137034) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871137034 |
| Entity Type | Individual |
| Full Name | JACOB BLACKWELL |
| Practice Address |
800 Kensington Ave Ste 203 Missoula MT 59801-5670 |
| Practice Telephone | 4062016501 |
| Mailing Telephone | 4062016501 |
| Enumeration Date | 2019-10-31 |
| Last Update Date | 2019-10-31 |
| 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) |
BBH-LAC-LIC-3315 | MT | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447782420 | Jacob Nazareth Blackwell | Student in an Organized Health Care Education/Training Program | 1215 Lee St, 800744, Charlottesville, VA 22908-0816 | 2017-03-30 |
| Street Address |
800 KENSINGTON AVE STE 203 |
| City | MISSOULA |
| State | MT |
| Zip Code | 59801-5670 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760670905 | Peter A Bornropp | Rehabilitation Counselor | 800 Kensington Ave Ste 203, Missoula, MT 59801-5670 | 2007-10-12 |
| 1447744099 | Sparrow Behavioral Health, LLC | Social Worker | 800 Kensington Ave Ste 203, Missoula, MT 59801-5670 | 2018-06-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629681010 | Time To Thrive Pllc | Social Worker | 1836 South Ave. West, Missoula, MT 59801 | 2020-08-26 |
| 1740815653 | Yuzo Fujiki | Specialist/Technologist | 210 N California St 104, Missoula, MT 59801 | 2020-03-11 |
| 1407346596 | Stepping Stones Counseling, Pllc | Counselor | 202 Brooks St Ste 300, Missoula, MT 59801 | 2018-05-14 |
| 1437668530 | Rejuve Care Clinic, Inc | Plastic Surgery | 715 Kensingten, Ste 1, Missoula, Missoula, MT 59801 | 2017-09-21 |
| 1619499555 | Beatrice Elise Powers | Specialist/Technologist | 410 B Stephens Ave, Missoula, MT 59801 | 2017-07-12 |
| 1770012197 | Hannah Lepiane | Massage Therapist | 1313 S. 4th W., Missoula, MT 59801 | 2017-06-08 |
| 1811420227 | Celeste Willis | Social Worker | 1055 W. Sussex, Missoula, MT 59801 | 2017-04-04 |
| 1073050498 | Rina Kasuga | Specialist/Technologist | 913 Rimini Ct, Missoula, MT 59801 | 2017-01-24 |
| 1043756919 | Heather Bartz | Specialist/Technologist | 831 Hastings Ave, Missoula, MT 59801 | 2017-01-16 |
| 1255874517 | Sarabeth Haddad | Social Worker | 1055 W Sussex Ave, Missoula, MT 59801 | 2016-11-18 |
| Find all providers in zip 59801 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922667062 | Patrick Ryan | Counselor | 1335 Wyoming St, Missoula, MT 59801-1725 | 2019-06-12 |
| 1497237648 | Leigh Ann Christian Lcsw, Lac Pllc | Counselor | 127 N Higgins Ave Ste 307d, Missoula, MT 59802-4486 | 2018-09-04 |
| 1407346596 | Stepping Stones Counseling, Pllc | Counselor | 202 Brooks St Ste 300, Missoula, MT 59801 | 2018-05-14 |
| 1831686088 | Darren Baird Ashby | Counselor | 202 Brooks St, Missoula, MT 59801-4019 | 2018-04-13 |
| 1508380569 | Lowell Owen Wavrick | Counselor | 4998 Sonoma St, Missoula, MT 59808-8694 | 2017-08-01 |
| 1649720319 | Andrea J Foran | Counselor | 700 South Ave W Ste B, Missoula, MT 59801-8011 | 2016-10-06 |
| 1922557123 | Candace Mirea | Counselor | 2809 Connery Way Ste B, Missoula, MT 59808-1955 | 2016-09-28 |
| 1316312150 | Greta Jernberg | Counselor | 800 Kensington Ave Ste Ll2, Missoula, MT 59801-5670 | 2015-12-04 |
| 1851766745 | Kali Neumeister | Counselor | 136 E Broadway St Ste 16, Missoula, MT 59802-4505 | 2015-12-03 |
| 1124418298 | Ronald Emmanuel Barker | Counselor | 1119 W Kent Ave Ste C, Missoula, MT 59801-6633 | 2015-01-28 |
| Find all providers in MISSOULA | ||||
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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.