MR. Willie Larry Blackmon, LCPC; CADC; MA
NPI #1477762052 in Hazel Crest, Illinois
Provider Information
- NPI Number
- 1477762052
- Entity Type
- Individual
- Name
- MR. Willie Larry Blackmon, LCPC; CADC; MA
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Counselor - Professional
- Credential
- LCPC; CADC; MA
- Enumeration Date
- May 21, 2007
- Last Updated
- Apr 23, 2009
Practice Location
- Address
- 17504 E CARRIAGEWAY DR STE B
- City
- Hazel Crest
- State
- Illinois
- ZIP Code
- 60429-2089
- Phone
- (708) 799-0300
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder) |
| Counselor - Mental Health — Mental Health |
| Counselor - Professional — Professional |
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