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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

MR. RAYMOND BLACKWELL LADAC II
NPI 1710599543
Counselor - Addiction (Substance Use Disorder) in Brush Creek, TN

Active since August 21, 2020PECOS Enrolled
832 MAIN ST SOUTH, BRUSH CREEK, TN 38547(615) 630-8908 Get Directions Write a Review

NPPES record last updated: August 10, 2026. Verified against the NPPES registry weekly; last sync: September 13, 2026.

Record update history: Aug 10, 2026, Sep 28, 2020, Aug 21, 2020 (3 updates tracked since 2020).

About Mr. Raymond Blackwell Ladac Ii NPPES

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

MR. RAYMOND BLACKWELL LADAC II (NPI 1710599543) is an individual addiction (substance use disorder) provider in Brush Creek, Tennessee, licensed in Tennessee (LDC0000001425) and active in the NPI registry since August 2020. He is enrolled in Medicare PECOS and maintains a secondary practice location in Brentwood.

NPPES Registry Identity

NPI1710599543
Entity TypeIndividualMale
Primary Taxonomy101YA0400X
Provider Legal NameMR. RAYMOND BLACKWELLCredential: LADAC II
Location Address832 MAIN ST SOUTHBrush Creek, TN 38547
Mailing Address811 Royal Elm CirHartsville, TN 37074-2004 · (615) 330-0161
Phone(615) 630-8908
Sole ProprietorYes
Enumeration DateAugust 21, 2020
Last NPPES UpdateAugust 10, 20263 updates tracked since enumeration
NPPES CertifiedAugust 10, 2026
✔ NPI 1710599543 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
License✔ Licensed in TN · LDC0000001425
832 MAIN ST SOUTH, Brush Creek, TN 38547
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Secondary Practice Location 1

Location 15511 Virginia Way Ste 300Brentwood, TN 37027-7611 · Phone (615) 994-1000 · Fax (615) 994-0100

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Raymond Blackwell Ladac Ii is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Raymond Blackwell's NPI number?

The NPI number for Raymond Blackwell is 1710599543. It was assigned to this individual provider in the NPPES registry on August 21, 2020.

Where is Raymond Blackwell located?

Raymond Blackwell practices at 832 Main St South, Brush Creek, TN 38547. The listed phone number is (615) 630-8908.

What is Raymond Blackwell's specialty?

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

Is Raymond Blackwell enrolled in Medicare?

Yes. Raymond Blackwell is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Raymond Blackwell was last updated on August 10, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 40 days 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.