Individual
NANCY J BLANTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
619 19TH STREET SOUTH, BIRMINGHAM, AL 35233
(205) 934-4011
Mailing address
PO BOX 55310, BIRMINGHAM, AL 35255-5310
(205) 731-9701
(205) 297-9411
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1700C
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051515656
BLUE CROSS BLUE SHIELD
AL
05
—
051515656
—
AL
01
—
051516276
FED BCBS OF AL
AL
01
—
330000005
MEDICAID REHAB
AL
Enumeration date
08/08/2006
Last updated
01/30/2012
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