KIM NELSON-BLACKBURN (LCSW) – Clinical Social Worker, NPI 1811294168

KIM NELSON-BLACKBURN (LCSW) is a healthcare provider. based in Delphi, Indiana. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LCSW. They hold a License No. 34004056A (IN). The NPI Number for KIM NELSON-BLACKBURN (LCSW) is 1811294168

Main info

Female
32 Years Of Experience
Accepts Medicare Assignment
Name
KIM NELSON-BLACKBURN (LCSW)
NPI
1811294168
Phone
(765) 564-2247
Address
1265 N BRADFORD DR
Enumeration Date
23 February 2011
Last Update Date
23 February 2011

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3175695433
Graduation Year
1994 (32 years ago)
PAC ID
9638351935
Group Practice PAC ID
0941648463
Professional Enrollment ID
I20110308000577
Address ID
IN460604370NO14540NXXX507
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience44
Completeness75
Years active:15State licenses:1Digital endpointsOther names

1,711 CLINICAL SOCIAL WORKER in IN

Provider Addresses for KIM NELSON-BLACKBURN (LCSW)

  • 1265 N BRADFORD DR

    DELPHI, IN 469239553

    Phone: (765) 564-2247

    Mailing address matches the actual address.

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.

This can happen when there are no reportable CMS Open Payments records.

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: 2011-03-08

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20110308000577IClinical Social WorkerINTBD

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.

Verify on CMS Revalidation Lookup Tool

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 46923)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0941648463View full group profile
NameSpecialtyState
Clinical Social WorkerMI
P S Y C H I A T R YMI
Clinical Social WorkerMI
Clinical Social WorkerIN
Clinical Social WorkerMI
P S Y C H I A T R YMI
Clinical Social WorkerMI
Mental Health CounselorOR
Clinical PsychologistOR
Marriage And Family TherapistWA

Reviews

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Frequently asked questions

Can I verify KIM NELSON-BLACKBURN (LCSW) with an NPI only?
You can start verification with NPI 1811294168 for KIM NELSON-BLACKBURN (LCSW), then check state licensing separately.
Does the file indicate KIM NELSON-BLACKBURN (LCSW) is practicing under active NPI?
Directory data currently reports KIM NELSON-BLACKBURN (LCSW) as active.
What taxonomy line describes KIM NELSON-BLACKBURN (LCSW)?
For research purposes, treat KIM NELSON-BLACKBURN (LCSW) as Clinical Social Worker in this dataset. Clinical services aligned with this taxonomy classification.
Does KIM NELSON-BLACKBURN (LCSW) list a practice location?
Patients near Delphi, Indiana may find KIM NELSON-BLACKBURN (LCSW) in results; validate coverage separately.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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