Tri'Na Elisa Blackshear
Counselor, Mental Health in Marianna, FL. Individual provider (NPI-1).
NPI number1083961775
StatusActive
Last updated in NPPESAug 13, 2012
Details
- NPI
- 1083961775
- Entity type
- Individual (NPI-1)
- Name
- Tri'Na Elisa Blackshear
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 13, 2012
- Last updated
- Aug 13, 2012
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | – | – | Yes |
Practice location
4254 Elm StMarianna, FL 32448-4210
Phone 850-272-8099
Mailing address
4254 Elm StMarianna, FL 32448-4210
Phone 850-272-8099
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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