KATHERINE LORA BLACKSTONE ALLEN (LICSW, MHP, CMHS) – Clinical Social Worker, NPI 1477785541

KATHERINE LORA BLACKSTONE ALLEN (LICSW, MHP, CMHS) is a healthcare provider. based in Longview, Washington. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LICSW, MHP, CMHS. They hold a License No. LW60424218 (WA). The NPI Number for KATHERINE LORA BLACKSTONE ALLEN (LICSW, MHP, CMHS) is 1477785541

Main info

Female
17 Years Of Experience
Accepts Medicare Assignment
Name
KATHERINE LORA BLACKSTONE ALLEN (LICSW, MHP, CMHS)
NPI
1477785541
Phone
(360) 200-5419
Address
910 16TH AVE STE 120
Enumeration Date
21 August 2009
Last Update Date
18 September 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3602005419
Graduation Year
2009 (17 years ago)
PAC ID
9133550650
Group Practice PAC ID
0941631469
Professional Enrollment ID
I20200515001379
Address ID
WA986322315LO748XXAVEX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience66
Completeness75
Years active:16State licenses:1Digital endpointsOther names

1,397 CLINICAL SOCIAL WORKER in WA

Provider Addresses for KATHERINE LORA BLACKSTONE ALLEN (LICSW, MHP, CMHS)

  • 910 16TH AVE STE 120

    LONGVIEW, WA 986322374

    Phone: (360) 200-5419

    Fax: (360) 200-6736

    Type: Location

  • 748, 14th Avenue, Longview, Cowlitz County, Washington, 98632, United States

    LONGVIEW, WA 98632

    Phone: (360) 200-5419

    Fax: (360) 200-6736

    Type: Location

  • Longview Post Office, Hillside Road, Longview Shops, Stockbridge Village, Page Moss, Huyton, Liverpool, Liverpool City Region, England, L36 8BJ, United Kingdom

    LONGVIEW, WA 986328455

    Phone: (360) 200-5419

    Fax: (360) 200-6736

    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.

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: 2020-05-15

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
I20200515001379IClinical Social WorkerWATBD

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 98632)

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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: 0941631469View full group profile
NameSpecialtyState
Nurse PractitionerWA
Mental Health CounselorWA
Clinical Social WorkerWA
Mental Health CounselorWA
Nurse PractitionerWA
Clinical Social WorkerWA
Nurse PractitionerWA
Nurse PractitionerWA

Reviews

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Frequently asked questions

What unique ID ties claims to KATHERINE LORA BLACKSTONE ALLEN (LICSW, MHP, CMHS)?
NPI 1477785541 is assigned to KATHERINE LORA BLACKSTONE ALLEN (LICSW, MHP, CMHS) under the national enumeration system.
Is KATHERINE LORA BLACKSTONE ALLEN (LICSW, MHP, CMHS)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What field does KATHERINE LORA BLACKSTONE ALLEN (LICSW, MHP, CMHS) work in?
You can think of KATHERINE LORA BLACKSTONE ALLEN (LICSW, MHP, CMHS) as practicing within Clinical Social Worker. Clinical services aligned with this taxonomy classification.
What location metadata exists for KATHERINE LORA BLACKSTONE ALLEN (LICSW, MHP, CMHS)?
The page summarizes Longview, Washington for KATHERINE LORA BLACKSTONE ALLEN (LICSW, MHP, CMHS); expand the address list for detail.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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