Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. WILLIE LARRY BLACKMON, LCPC; CADC; MA
ActiveMR. WILLIE LARRY BLACKMON, LCPC; CADC; MA is a Professional Counselor healthcare provider located in HAZEL CREST, Illinois. NPI 1477762052 is currently active in the NPPES registry. Verify at CMS.
Professional Counselor · HAZEL CREST, IL
Registration Details
- NPI Number
- 1477762052
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- May 21, 2007 (19.20328483786 yrs)
- Last Updated
- Apr 23, 2009
- Licenses
-
5848 (IL)178-002766 (IL)180.007189 (IL)
Practice Information
- Address
-
17504 E CARRIAGEWAY DR STE BHAZEL CREST, IL, 604292089Browse IL providers · Browse ZIP 60429
- Phone
- 7087990300
- Fax
- 7087990300
- Primary Specialty
-
Professional Counselor
101YP2500X
- Additional Specialty
- Mental Health Counselor
- Additional Specialty
- Professional Counselor
Other Professional Counselor Providers in HAZEL CREST, IL
| Name | Credential | NPI |
|---|---|---|
| MRS. PAMELA ELAINE GEDDES | MA | 1386857969 |
| MS. AISHA SANDERS | LCPC | 1922438555 |
| ANITA JAMISON | — | 1356744338 |
| RALPH YANIZ | MSW | 1427439645 |
| MICHAEL CHRISTAKOS | — | 1811447337 |
| DOROTHY KUKLINSKI | M.A., LPC | 1487199089 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.