Blackbourn, Sheila
Blackbourn, Sheila is an sole proprietor health care provider with primary practice located at 7794 S Golden Bell Dr , Tucson AZ 85747-0088. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / School. Behavioral Health & Social Service Providers / School is her primary health care specialty. Blackbourn, Sheila can be contacted via phone (575) 706-6611.Contact Information
Primary practice address
7794 S Golden Bell Dr
Tucson AZ 85747-0088
Phone: (575) 706-6611
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 15846 | Arizona |
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | I05261 | New Mexico |
| Behavioral Health & Social Service Providers / School | 1041S0200X | 317372 | New Mexico |
Profile Details
| NPI number | 1891776373 |
|---|---|
| LBN Legal business name | Blackbourn, Sheila |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 10th, 2005 |
| Last updated | Aug 31st, 2023 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1891776373 | NPPES |
| New Mexico | MEDICAID | 18256066 |
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