Blackwell, Jay

Blackwell, Jay is an individual health care provider with primary practice located at 3150 Carlisle Blvd Ne Ste 105 , Albuquerque NM 87110-1680. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Other Service Providers / Peer Specialist. Other Service Providers / Peer Specialist is his primary health care specialty. Blackwell, Jay can be contacted via phone (505) 652-4659.

Contact Information

Primary practice address
3150 Carlisle Blvd Ne Ste 105 Albuquerque NM 87110-1680
Phone: (505) 652-4659
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X CTL0223091 New Mexico
Other Service Providers / Peer Specialist 175T00000X 1241 New Mexico

Profile Details

NPI number 1063178440
LBN Legal business name Blackwell, Jay
Credentials MA, CPSW, LMHC
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 10th, 2021
Last updated Feb 23rd, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063178440 NPPES
New Mexico Other CTL0223091 NM REGULATION AND LICENSING DEPARTMENT
New Mexico Other 1241 NM REGULATION AND LICENSING DEPARTMENT

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