JACK BLACKWELL RADT
NPI 1215574561
Counselor - Addiction (Substance Use Disorder) in Woodland, CA
Active since December 05, 2019
About Jack Blackwell Radt NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JACK BLACKWELL RADT (NPI 1215574561) is an individual addiction (substance use disorder) provider in Woodland, California and active in the NPI registry since December 2019.
NPPES Registry Identity
NPI1215574561
Entity TypeIndividualMale
Primary Taxonomy101YA0400X
Provider Legal NameJACK BLACKWELLCredential: RADT
Location Address215 W BEAMER STWoodland, CA 95695-2510
Mailing Address215 W Beamer StWoodland, CA 95695-2510 · (530) 405-2815
Phone(530) 405-2815
Sole ProprietorNo
Enumeration DateDecember 5, 2019
Last NPPES UpdateSeptember 28, 20203 updates tracked since enumeration
NPPES CertifiedSeptember 28, 2020
✔ NPI 1215574561 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
215 W BEAMER ST, Woodland, CA 95695
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
Student in an Organized Health Care Education/Training Program
215 W BEAMER ST
WOODLAND, CA 95695
WOODLAND, CA 95695
Counselor (Addiction (Substance Use Disorder))
215 W BEAMER ST
WOODLAND, CA 95695
WOODLAND, CA 95695
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1215574561, enumerated as an "individual" on December 05, 2019.
The provider is located at 215 W BEAMER ST WOODLAND, CA 95695 and the phone number is (530) 405-2815.
Counselor with taxonomy code 101YA0400X and a focus in Addiction (Substance Use Disorder).
