MRS. STEPHANIE ANNE BLACKBURN LCSW
NPI 1700197159
Social Worker - Clinical in Charlotte, NC

Q: What is Stephanie Blackburn's NPI number?

The NPI number for Stephanie Blackburn is 1700197159. It was assigned to this individual provider in the NPPES registry on June 30, 2010.

Q: What is Stephanie Blackburn's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Active since June 30, 2010PECOS EnrolledAccepts Medicare Assignment

4412 PARK RD, CHARLOTTE, NC 28209(980) 217-6901 Get Directions Write a Review

NPPES record last updated: January 10, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Mrs. Stephanie Anne Blackburn Lcsw NPPES

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

MRS. STEPHANIE ANNE BLACKBURN LCSW (NPI 1700197159) is an individual clinical provider in Charlotte, North Carolina, licensed in North Carolina (C007732) and active in the NPI registry since June 2010. She is enrolled in Medicare PECOS and is a graduate of Other (2008).

NPPES Registry Identity

NPI1700197159

Entity TypeIndividualFemale

Primary Taxonomy1041C0700X

Provider Legal NameMRS. STEPHANIE ANNE BLACKBURNCredential: LCSW

Location Address4412 PARK RDCharlotte, NC 28209-3130

Mailing Address7503 Potter Rd SWaxhaw, NC 28173-9242 · (704) 759-6168

Phone(980) 217-6901

Sole ProprietorNo

Medical School CMSOtherGraduated 2008

Enumeration DateJune 30, 2010

Last NPPES UpdateJanuary 10, 2024

NPPES CertifiedJanuary 10, 2024

✔ NPI 1700197159 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code1041C0700X

License✔ Licensed in NC · C007732

Definition

A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.

4412 PARK RD, Charlotte, NC 28209

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource, Cigna Healthcare, Oscar Health Plan of North Carolina, Inc and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mrs. Stephanie Anne Blackburn Lcsw 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 ID1456704865

PECOS Enrollment IDI20240201000264

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.

Medicare Billing Reassignment

Medicare enrollment records show Stephanie Blackburn reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Thriveworks Clinical - North Carolina PC

134 mi

Mental Health

8406 SIX FORKS RD STE 104
Raleigh, NC 27615

Reassigned Medicare billing, North Carolina enrollment
188 clinicians in this Medicare group

NPI 1003303082 (919) 424-6045

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28209 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$0.00 typical visit price

range $54.12 – $165.09

Typical copayment $0.00 (range $13.53 – $41.27)

Most-billed visit code NA

Established Patient

$67.72 typical visit price

range $17.21 – $134.61

Typical copayment $16.93 (range $4.30 – $33.65)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 8

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

BRIAN JAMES ROBERTSON LCSW

Social Worker (Clinical)