Individual provider · NPI-1

Mikki G Blackman, MSW

Social Worker, Clinical · Summerville, SC

NPI number1629116751
StatusActive
Last updated in NPPESSep 15, 2022

Details

NPI
1629116751
Entity type
Individual (NPI-1)
Name
Ms. Mikki G Blackman
Credential
MSW
Sex
Female
Sole proprietor
Yes
Enumeration date
Feb 1, 2007
Certification date
Sep 15, 2022
Last updated
Sep 15, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1041C0700X Social Worker, Clinical002387SCYes

Other names

  • Mikki Blackman (Professional Name)

Practice location

108 Rutherford St
Summerville, SC 29483

Phone 843-437-5994 · Fax 843-875-2189

Mailing address

108 Rutherford St
Summerville, SC 29483

Phone 843-437-5994 · Fax 843-875-2189

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