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

Grace M Blackwood, LPC

Individual provider Mental Health Counselor · NPI 1104071133

Grace M Blackwood, LPC is an Undefined Non-Physician Type (Specify) in Fairburn, Georgia. Qualified in 1992, 34 years ago. Practices with Grady Memorial Hospital Corporation, a 363-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Georgia.

Years since qualifying
34
Licensed in
GA
In the registry since
2008
What do these letters mean?
LPC — Licensed Professional Counselor
A licensed mental health counsellor.

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Practice location Address checks out

570 Windsor Way
Fairburn, GA 30213-6446
Phone: (770) 365-3140
Fax: (770) 703-7915
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence LPC004495 (GA)

Record details

NPI number1104071133
Entity typeIndividual (Type 1)
GenderFemale
Credentials LPC
Sole proprietorYes
NPI enumeratedNovember 18, 2008
Last updated in NPPESJanuary 26, 2016

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyUNDEFINED NON-PHYSICIAN TYPE (SPECIFY)
Medical schoolOTHER
Graduated 1992 (34 years in practice)
Group practice Grady Memorial Hospital Corporation — 363 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Fairburn