BRANDI DAWN BLACKWELL — NPI 1639716350 (Licensed & Credentialed Behavioral Health & Social Service Providers

CMS-1500 Box 24J / 33a • NPI

1639716350

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

106S00000X (CMS 62)

Licensed & Credentialed Behavioral Health & Social Service Providers — Technician

Box 32 Service Location & ZIP+4

125 TIBET AVE APT 116A, SAVANNAH, GA, 31406-5550

✓ 9-Digit EDI 837 ZIP+4 (31406-5550)

Practice Phone & Referral Fax

(912) 507-1159

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1639716350 (BRANDI DAWN BLACKWELL) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1639716350` (NPI-1 Individual Practitioner)
Provider / Legal Name	BRANDI DAWN BLACKWELL
Plain-English Specialty	Licensed & Credentialed Behavioral Health & Social Service Providers — Technician NUCC Code: `106S00000X` (Behavior Technician)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	125 TIBET AVE APT 116A, SAVANNAH, GA, 31406-5550
Practice Telephone / Fax	Tel: (912) 507-1159
Administrative Mailing Address	316 MID VALLEY CTR # 186, CARMEL, CA, 93923-8516
Enumeration & Last Sync	Enumerated: 2019-12-01 \| CMS Record Updated: 2019-12-01

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

125 TIBET AVE APT 116A, SAVANNAH, GA, 31406-5550

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Plain-English Taxonomy & CMS Crosswalk (106S00000X)

What Does Taxonomy Code 106S00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 106S00000X translates to:
"Licensed & Credentialed Behavioral Health & Social Service Providers — Technician"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 62 (Psychologist, Clinical)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Behavior Technician for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (BRANDI DAWN BLACKWELL)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`106S00000X` — Behavior Technician Plain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Technician	State: N/A \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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BRANDI DAWN BLACKWELL (NPI #1639716350)