Individual
DERICA BLACKMON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
307 W POPLAR ST, MC GEHEE, AR 71654-2548
(870) 222-7314
Mailing address
307 W POPLAR ST, MC GEHEE, AR 71654-2548
(870) 222-7314
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
26359-M
AR
1041C0700X
Clinical Social Worker
26359-M
AR
Other
Enumeration date
12/25/2025
Last updated
01/04/2026
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