Provider Demographics
NPI:1619630449
Name:BLANKENSHIP, CELESTE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:CELESTE
Middle Name:
Last Name:BLANKENSHIP
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 PALOMINO DR
Mailing Address - Street 2:
Mailing Address - City:NORTH ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01845-3377
Mailing Address - Country:US
Mailing Address - Phone:561-254-6688
Mailing Address - Fax:
Practice Address - Street 1:66 PALOMINO DR
Practice Address - Street 2:
Practice Address - City:NORTH ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845-3377
Practice Address - Country:US
Practice Address - Phone:561-254-6688
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-19
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty