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

Ellie A Blackburn

Individual provider Clinical Social Worker · NPI 1861254518

Ellie A Blackburn is a Clinical Social Worker in Grand Rapids, Michigan. Licensed in Michigan. Registered with an NPI since 2024.

Licensed in
MI
In the registry since
2024

Practice location Address checks out

678 Frnt Ave NW
Grand Rapids, MI 49504-5325
Phone: (616) 916-3711
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 6851121335 (MI)

Record details

NPI number1861254518
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJanuary 29, 2024
Last updated in NPPESFebruary 3, 2026
Certification dateFebruary 3, 2026

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