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

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1215574561

Jack Blackwell, RADT is an Addiction (Substance Use Disorder) Counselor in Woodland, California. Registered with an NPI since 2019.

In the registry since
2019
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Practice location Address checks out

215 W Beamer St
Woodland, CA 95695-2510
Phone: (530) 405-2815
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X

Record details

NPI number1215574561
Entity typeIndividual (Type 1)
GenderMale
Credentials RADT
Sole proprietorNo
NPI enumeratedDecember 5, 2019
Last updated in NPPESSeptember 28, 2020
Certification dateSeptember 28, 2020
Mailing address215 W Beamer St, Woodland, CA 95695-2510

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