Individual
CINDY BLACKLIDGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1177 PERSHING AVE, FORT EUSTIS, VA 23604-1406
(573) 587-6001
Mailing address
5116 N HIGHWAY 61, SAINT MARY, MO 63673-7102
(573) 587-6001
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
0904017812
VA
1041C0700X
Clinical Social Worker
Primary
2017043723
MO
1041C0700X
Clinical Social Worker
C10541
MS
Other
Enumeration date
12/08/2020
Last updated
01/20/2025
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