Davis, Joan Blackwood

Davis, Joan Blackwood is an individual health care provider with primary practice located at 3008 Bevcher Dr , Madison IN 47250-3863. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Psychologist. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Davis, Joan Blackwood can be contacted via phone (812) 265-1918.

Contact Information

Primary practice address
3008 Bevcher Dr Madison IN 47250-3863
Phone: (812) 265-1918
Fax: (812) 265-1828
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 20041196A Indiana
Behavioral Health & Social Service Providers / Psychologist 103T00000X 20041196A Indiana

Profile Details

NPI number 1114999372
LBN Legal business name Davis, Joan Blackwood
Credentials HSPP
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 2nd, 2006
Last updated May 6th, 2014 - about 12 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114999372 NPPES
Indiana MEDICAID 200172180A
Indiana Other 000000209017

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