Individual
DIANE BLACKMON
Active
Individual
DIANE BLACKMON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW-C
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
26801
MD
1041C0700X
Clinical Social Worker
C018447
NC
Other
Enumeration date
05/16/2020
Last updated
09/01/2026
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