| Richard C. Blackford, Ph.d. P.c. | |
|
1444 W 38th St Erie PA 16508-2346 | |
| (814) 835-7043 | |
| (814) 838-2925 |
| Full Name | Richard C. Blackford, Ph.d. P.c. |
|---|---|
| Speciality | Psychologist |
| Location | 1444 W 38th St, Erie, Pennsylvania |
| Authorized Official Name and Position | Richard C. Blackford (PSYCHOLOGIST) |
| Authorized Official Contact | 8148357043 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Richard C. Blackford, Ph.d. P.c. 1444 W 38th St Erie PA 16508-2346 Ph: (814) 835-7043 | Richard C. Blackford, Ph.d. P.c. 1444 W 38th St Erie PA 16508-2346 Ph: (814) 835-7043 |
| NPI Number | 1144615600 |
|---|---|
| Provider Enumeration Date | 04/01/2015 |
| Last Update Date | 10/05/2016 |
| Medicare PECOS PAC ID | 9234449976 |
|---|---|
| Medicare Enrollment ID | O20151109000300 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144615600 | NPI | - | NPPES |
| 1053318360 | Other | PERSONAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PS006224L (Pennsylvania) | Primary |
| Provider Name | Richard C Blackford |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1053318360 PECOS PAC ID: 3678756269 Enrollment ID: I20110318000596 |
| Provider Name | Mary Blackford |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891240750 PECOS PAC ID: 3476891250 Enrollment ID: I20190221000922 |
| Provider Name | Mikaela Mckee |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487199808 PECOS PAC ID: 7618234154 Enrollment ID: I20200416000833 |
| Provider Name | Amy Elizabeth Boxer |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1831769496 PECOS PAC ID: 0547600926 Enrollment ID: I20240502000847 |
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