Provider Demographics
NPI:1548982713
Name:BLACKHAT, APRIL ROSE (CADC-I)
Entity type:Individual
Prefix:
First Name:APRIL
Middle Name:ROSE
Last Name:BLACKHAT
Suffix:
Gender:F
Credentials:CADC-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 BLUFFS AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:ELKO
Mailing Address - State:NV
Mailing Address - Zip Code:89801-2466
Mailing Address - Country:US
Mailing Address - Phone:775-738-4158
Mailing Address - Fax:775-778-9501
Practice Address - Street 1:215 BLUFFS AVE STE 100
Practice Address - Street 2:
Practice Address - City:ELKO
Practice Address - State:NV
Practice Address - Zip Code:89801-2466
Practice Address - Country:US
Practice Address - Phone:775-738-4158
Practice Address - Fax:775-778-9501
Is Sole Proprietor?:No
Enumeration Date:2022-09-14
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
2086969369OtherPHONE NUMBER