Provider Demographics
NPI:1699825810
Name:BLACKBURN, BARBARA J (MC LMHC)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:J
Last Name:BLACKBURN
Suffix:
Gender:F
Credentials:MC LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1136 N 115TH ST
Mailing Address - Street 2:UNIT A-106
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-8358
Mailing Address - Country:US
Mailing Address - Phone:206-354-8263
Mailing Address - Fax:206-628-0839
Practice Address - Street 1:1370 STEWART ST
Practice Address - Street 2:SUITE 210
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-5424
Practice Address - Country:US
Practice Address - Phone:206-354-8263
Practice Address - Fax:206-628-0839
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00007200101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health