Individual
JAY BLACKWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, LPCC
Contact information
Practice address
3150 CARLISLE BLVD NE STE 105, ALBUQUERQUE, NM 87110-1680
(505) 652-4659
Mailing address
3150 CARLISLE BLVD NE STE 105, ALBUQUERQUE, NM 87110-1680
(505) 652-4659
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
CTL0223091
NM
101YP2500X
Professional Counselor
Primary
CTB-2026-0236
NM
175T00000X
Peer Specialist
1241
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1241
OFFICE OF PEER RECOVERY AND ENGAGEMENT
NM
01
—
CTB20260236
NMRLD
NM
01
—
CTL0223091
NM REGULATION AND LICENSING DEPARTMENT
NM
Enumeration date
11/10/2021
Last updated
03/20/2026
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