DR. MILDRED L BLACKFORD (PHD) – Clinical Psychologist, NPI 1740282110
Clinical Psychologist
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NPPES metrics only — not quality of care.
450 CLINICAL PSYCHOLOGIST in IN
Provider Addresses for DR. MILDRED L BLACKFORD (PHD)
200, North Shadeland Avenue, Indianapolis, Marion, Indiana, 46219, United States
INDIANAPOLIS, IN 462194959
Phone: (317) 962-3834
Type: Mailing
2100 N MAIN ST # 304
CROWN POINT, IN 463071877
Phone: (574) 546-1900
Fax: (574) 546-1999
Type: Location
550 University Blvd
Indianapolis, IN 462025149
Phone: (317) 944-5998
Type: Location
355 W 16th St.
Suite 2800
Indianapolis, IN 462022207
Phone: (317) 963-7070
Fax: (317) 257-5300
Type: Location
Goodman Campbell Brain and Spine, 355, West 16th Street, Indianapolis, Marion, Indiana, 46224, United States
SUITE 2800
INDIANAPOLIS, IN 462022207
Phone: (317) 963-7070
Fax: (317) 257-5300
Type: Location
250 N SHADELAND AVE
INDIANAPOLIS, IN 462194959
Phone:
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
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Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2016-03-29
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20160329001594 | I | Clinical Psychologist | IN | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 46219)
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