Individual
SEAN M BLACKBURN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
120 KENTUCKY AVE STE 110, LEXINGTON, KY 40502-1978
(502) 409-6993
(502) 409-6775
Mailing address
431 DARBY CREEK RD APT D, LEXINGTON, KY 40509-1290
(859) 619-7475
(931) 901-1239
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1500
KY
Other
Enumeration date
09/24/2018
Last updated
09/24/2018
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