Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Angelique Nicole Blackwell, CGG61649106

Individual provider Counselor · NPI 1831904218

Angelique Nicole Blackwell, CGG61649106 is a Counselor in Renton, Washington. Licensed in Washington. Registered with an NPI since 2025.

Licensed in
WA
In the registry since
2025
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Practice location Address checks out

15 S Grady Way Ste 245
Renton, WA 98057-3209
Phone: (206) 679-8291
Fax: (206) 274-6252
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Counselor (primary) Taxonomy 101Y00000X · Licence CG61649160 (WA)

Record details

NPI number1831904218
Entity typeIndividual (Type 1)
GenderFemale
Credentials CGG61649106
Sole proprietorNo
NPI enumeratedFebruary 11, 2025
Last updated in NPPESFebruary 11, 2025
Certification dateFebruary 11, 2025

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