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Active NPI 1477762052 Individual Practitioner Male Practitioner

Willie Larry Blackmon , LCPC, CADC, MA

Counselor - Professional • Hazel Crest, IL

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Willie Blackmon, LCPC, CADC, MA is a certified Counselor - Professional practicing in Hazel Crest, IL. With approximately 25 years of clinical experience since completing medical education in 2001, Willie Blackmon delivers high-quality medical care to the local community at 17504 E CARRIAGEWAY DR STE B.

Willie Blackmon accepts Medicare assignment.

Practice Location & Contact Primary Location

Practice Address

17504 E Carriageway Dr Ste B

Hazel Crest, IL 604292089

Telephone 7087990300
Fax 7087990300
Associated Practice Facility / Clinic

Medicare Profile & Education

Medical School

Other

Graduation Year

2001

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Counselor - Professional in Hazel Crest, IL

Senior Veteran Specialist (>20 Yrs)
Practitioner Clinical Experience
25 Yrs -3.5 yrs vs City Avg
City Avg: 28.5 Yrs
State Avg: 17.0 Yrs
Regional Practice Density
10 Specialists

Practicing in Hazel Crest, IL (9683 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Blackmon (25 Years) 25 Yrs
Hazel Crest Specialty Average (28.5 Years) 28.5 Yrs

Medical Specialties & State Licenses

Counselor - Professional Primary Specialty

NUCC Taxonomy Code: 101YP2500X

State License IL 180.007189

Definition to come...

Counselor - Addiction (Substance Use Disorder)

NUCC Taxonomy Code: 101YA0400X

State License IL 5848

Definition to come...

Counselor - Mental Health

NUCC Taxonomy Code: 101YM0800X

State License IL 178-002766

Definition to come...

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

4 Associated Practitioners
Pamela Geddes , MA

Counselor - Professional

NPI 1386857969

Master of Arts

Keith Renfroe , MA

Counselor - Professional

NPI 1538386552

Master of Arts

Denise Mercherson

Social Worker - Clinical

NPI 1598293839
Aisha Sanders , LCPC

Counselor - Professional

NPI 1922438555

Licensed Clinical Professional Counselor

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active April 23, 2009

NPI status registered as active in NPPES database

📍
Updated Practice Location April 23, 2009

Registered at 17504 E CARRIAGEWAY DR STE B, HAZEL CREST, IL 604292089 (Tel: 7087990300)

📍
Updated Business Mailing Address April 23, 2009

Registered at 5834 S MAPLEWOOD AVE, CHICAGO, IL 606291124 (Tel: 7737784835)

👤
Provider Name / Credentials Updated April 23, 2009

Recorded as WILLIE BLACKMON, LCPC; CADC; MA

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 23, 2009

Counselor (License #5848 in IL)

🟢
Initial NPI Registration & Enumeration May 21, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1477762052
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 21, 2007
Last Update: April 23, 2009
Sole Proprietor: No

Mailing Address

5834 S Maplewood Ave

Chicago, IL 606291124

Phone: 7737784835

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.