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KIMBERLY ANNE BLACKMON LPC, NCC, LCAS, CCS
NPI 1083747224
Counselor - Addiction (Substance Use Disorder) in Charlotte, NC

Active since March 14, 2007
429 BILLINGSLEY RD, MECKLENBURG COUNTY AMH SASC, CHARLOTTE, NC 28211(704) 336-5651(704) 336-5105 Get Directions Write a Review

NPPES record last updated: October 22, 2014. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Kimberly Anne Blackmon Lpc, Ncc, Lcas, Ccs NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KIMBERLY ANNE BLACKMON LPC, NCC, LCAS, CCS (NPI 1083747224) is an individual addiction (substance use disorder) provider in Charlotte, North Carolina, licensed in North Carolina (398) and active in the NPI registry since March 2007.

NPPES Registry Identity

NPI1083747224
Entity TypeIndividualFemale
Primary Taxonomy101YA0400X
Provider Legal NameKIMBERLY ANNE BLACKMONCredential: LPC, NCC, LCAS, CCS
Location Address429 BILLINGSLEY RD, MECKLENBURG COUNTY AMH SASCCharlotte, NC 28211-1007
Mailing Address12631 Bullock Greenway BlvdCharlotte, NC 28277-8177 · (980) 245-8433
Phone(704) 336-5651
Fax(704) 336-5105
Sole ProprietorYes
Enumeration DateMarch 14, 2007
Last NPPES UpdateOctober 22, 2014
✔ NPI 1083747224 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License✔ Licensed in NC · 398
Also ListedCounselor · ProfessionalTaxonomy 101YP2500X · License 3706S (NC)
429 BILLINGSLEY RD, Charlotte, NC 28211
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Other Names 1

Former Name (1)Kimberly Anne Phillips Lpcs, Lcas, Ccs, Ncc

Other Identifiers 1

Medicaid6102838NC

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JOHN SCOTT
Counselor (Addiction (Substance Use Disorder))
429 BILLINGSLEY RD
CHARLOTTE, NC 28211
Mecklenburg County (704) 445-6900
MR. TONY RAY BEATTY LCAS, CCS
Counselor (Addiction (Substance Use Disorder))
429 BILLINGSLEY RD
CHARLOTTE, NC 28211
Mecklenburg County (704) 336-3067
MRS. MARTHA KARRIKER HALL MA, LPC
Counselor (Professional)
429 BILLINGSLEY RD
CHARLOTTE, NC 28211
Mecklenburg County (704) 432-3992
MR. DAVID ATWELL HAMBY M.A., LCAS
Counselor (Addiction (Substance Use Disorder))
429 BILLINGSLEY RD
CHARLOTTE, NC 28211
Mecklenburg County (704) 336-5640
AUTUMN SHERE' WOODARD LCSW, LCAS
Social Worker (Clinical)
429 BILLINGSLEY RD
CHARLOTTE, NC 28211
Mecklenburg County (704) 445-6900
TAMARA VAUGHT LCASA
Counselor (Addiction (Substance Use Disorder))
429 BILLINGSLEY RD
CHARLOTTE, NC 28211
Mecklenburg County (704) 445-6900
MS. BEVERLY HELEN BROOKSHIRE MS
Counselor (Addiction (Substance Use Disorder))
429 BILLINGSLEY RD
CHARLOTTE, NC 28211
Mecklenburg County (704) 336-5634
LEROINESSA JOVONDA ABRAHAM
Counselor (Addiction (Substance Use Disorder))
429 BILLINGSLEY RD
CHARLOTTE, NC 28211
Mecklenburg County (704) 445-6900

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kimberly Blackmon's NPI number?

The NPI number for Kimberly Blackmon is 1083747224. It was assigned to this individual provider in the NPPES registry on March 14, 2007. The provider is also known as Kimberly Anne Phillips Lpcs, Lcas, Ccs, Ncc.

Where is Kimberly Blackmon located?

Kimberly Blackmon practices at 429 Billingsley Rd Mecklenburg County Amh Sasc, Charlotte, NC 28211. The listed phone number is (704) 336-5651.

What is Kimberly Blackmon's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Kimberly Blackmon was last updated on October 22, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.