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GRACE M BLACKWOOD LPC
NPI 1104071133
Counselor - Mental Health in Fairburn, GA

Active since November 18, 2008PECOS EnrolledAccepts Medicare Assignment
570 WINDSOR WAY, FAIRBURN, GA 30213(770) 365-3140(770) 703-7915 Get Directions Write a Review

NPPES record last updated: January 26, 2016. Verified against the NPPES registry weekly; last sync: August 30, 2026.

About Grace M Blackwood Lpc NPPES

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

GRACE M BLACKWOOD LPC (NPI 1104071133) is an individual mental health provider in Fairburn, Georgia, licensed in Georgia (LPC004495) and active in the NPI registry since November 2008. She is enrolled in Medicare PECOS and is a graduate of Other (1992).

NPPES Registry Identity

NPI1104071133
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameGRACE M BLACKWOODCredential: LPC
Location Address570 WINDSOR WAYFairburn, GA 30213-6446
Mailing Address570 Windsor WayFairburn, GA 30213-6446 · (770) 365-3140 · Fax (770) 703-7915
Phone(770) 365-3140
Fax(770) 703-7915
Sole ProprietorYes
Medical School CMSOtherGraduated 1992
Enumeration DateNovember 18, 2008
Last NPPES UpdateJanuary 26, 2016
✔ NPI 1104071133 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in GA · LPC004495
570 WINDSOR WAY, Fairburn, GA 30213
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Grace M Blackwood Lpc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9830514678
PECOS Enrollment IDI20200810003592
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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 Grace Blackwood's NPI number?

The NPI number for Grace Blackwood is 1104071133. It was assigned to this individual provider in the NPPES registry on November 18, 2008.

Where is Grace Blackwood located?

Grace Blackwood practices at 570 Windsor Way, Fairburn, GA 30213. The listed phone number is (770) 365-3140.

What is Grace Blackwood's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Grace Blackwood enrolled in Medicare?

Yes. Grace Blackwood is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Grace Blackwood was last updated on January 26, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.