Provider Demographics
NPI:1598061913
Name:BLACKBURN COUNSELING & CONSULTATION
Entity Type:Organization
Organization Name:BLACKBURN COUNSELING & CONSULTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:
Authorized Official - Last Name:BLACKBURN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:615-776-5393
Mailing Address - Street 1:875 ARLINGTON HEIGHTS DR
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-8159
Mailing Address - Country:US
Mailing Address - Phone:615-776-5393
Mailing Address - Fax:615-844-6115
Practice Address - Street 1:1616 WESTGATE CIR
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-8019
Practice Address - Country:US
Practice Address - Phone:615-844-6114
Practice Address - Fax:615-844-6115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-02
Last Update Date:2011-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN9031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty