Mr Willie Larry Blackmon, LCPC; CADC; MA in Hazel Crest, IL

Mr Willie Larry Blackmon, LCPC; CADC; MA is a medicare enrolled "Counselor - Professional" provider in Hazel Crest, Illinois. His current practice location is 17504 E Carriageway Dr Ste B, Hazel Crest, Illinois. You can reach out to his office (for appointments etc.) via phone at (708) 799-0300.

Mr Willie Larry Blackmon is licensed to practice in Illinois (license number 180.007189) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1477762052.

Contact Information

	Mr Willie Larry Blackmon, LCPC; CADC; MA
	17504 E Carriageway Dr Ste B, Hazel Crest, IL 60429-2089
	(708) 799-0300
	(708) 799-0300

Map and Direction

Healthcare Provider's Profile

Full Name	Mr Willie Larry Blackmon
Gender	Male
Speciality	Counselor - Professional
Location	17504 E Carriageway Dr Ste B, Hazel Crest, Illinois
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1477762052
Provider Enumeration Date: 05/21/2007
Last Update Date: 04/23/2009

Medicare PECOS Information:

PECOS PAC ID: 1557899366
Enrollment ID: I20250107003508

Medical Identifiers

Medical identifiers for Mr Willie Larry Blackmon such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1477762052	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YA0400X	Counselor - Addiction (substance Use Disorder)	5848 (Illinois)	Secondary
101YM0800X	Counselor - Mental Health	178-002766 (Illinois)	Secondary
101YP2500X	Counselor - Professional	180.007189 (Illinois)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mr Willie Larry Blackmon allows following entities to bill medicare on his behalf.

Entity Name	Blackmon Counseling Services
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1154754547 PECOS PAC ID: 1759819550 Enrollment ID: O20250107003327

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Willie Larry Blackmon is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mr Willie Larry Blackmon, LCPC; CADC; MA 5834 S Maplewood Ave, Chicago, IL 60629-1124 Ph: (773) 778-4835	Mr Willie Larry Blackmon, LCPC; CADC; MA 17504 E Carriageway Dr Ste B, Hazel Crest, IL 60429-2089 Ph: (708) 799-0300

Reviews and Comments

Counselor in Hazel Crest, IL

Cara Catlett, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1909 Cheker Sq, Hazel Crest, IL 60429 Phone: 708-331-0500
Jack Lamont Solomon Jr., Counselor Medicare: Not Enrolled in Medicare Practice Location: 17055 Jodave Ave, Hazel Crest, IL 60429 Phone: 773-269-0691
Divine Braboy, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 3704 Briar Ln, Hazel Crest, IL 60429 Phone: 773-563-7670
Mrs. Lisa Michelle Steward-baugh, LSW, QMHP Counselor Medicare: Not Enrolled in Medicare Practice Location: 3407 Montmarte Ave, Hazel Crest, IL 60429 Phone: 708-439-9788
Dr. Bonita Husband, CRC Counselor Medicare: Not Enrolled in Medicare Practice Location: 7 E Carriageway Dr # 503, Hazel Crest, IL 60429 Phone: 773-383-7907
Shirley Jean Hightower, CADC, MISA Counselor Medicare: Not Enrolled in Medicare Practice Location: 17100 Dixie Hwy Ste D, Hazel Crest, IL 60429 Phone: 708-335-1155 Fax: 708-335-1171
Anita Jamison, Counselor Medicare: Not Enrolled in Medicare Practice Location: 17064 Shea Ave, Hazel Crest, IL 60429 Phone: 708-955-4540

Mr Willie Larry Blackmon, LCPC; CADC; MA - Medicare Counselor in Hazel Crest, IL