Individual
VANESSA NIKITTA BLACKWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCAS
Contact information
Practice address
696 S SCALES ST, REIDSVILLE, NC 27320-5024
(833) 510-4357
(866) 460-2997
Mailing address
4600 MONTGOMERY RD STE 400, CINCINNATI, OH 45212-2600
(833) 510-4357
(866) 460-2997
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCAS-1653
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6112290
—
NC
Enumeration date
10/14/2011
Last updated
01/10/2025
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