Mary Blomgren, CASAC. LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

010099-01 Issued in NY

Practice address

79 N Clinton Ave
Rochester, NY 14604-1407

Phone

(315) 331-2300

NPI assigned

Mar 24, 2017

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Catholic Charities of the Diocese of Rochester

  • Community/Behavioral Health Agency
  • Rochester, NY
  • NPI 1790853844

  Addiction (Substance Use Disorder)

  NPD
• Agape Counseling Associates Inc

  • Clinical Social Worker
  • Penfield, NY
  • NPI 1174657712
  NPD (past)
• Catholic Charities of the Diocese of Rochester

  • Substance Abuse Rehabilitation Facility
  • Newark, NY
  • NPI 1548705387
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1490313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674604800000",
    "number": "1003347626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79 N CLINTON AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146041407",
            "telephone_number": "585-397-4648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 N CLINTON AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146041407",
            "telephone_number": "315-331-2300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Agape Counseling Associates Inc.",
            "address_2": "21 Willow Pond Way #103",
            "address_purpose": "LOCATION",
            "city": "Penfield",
            "state": "NY",
            "postal_code": "14526",
            "country_code": "US",
            "telephone_number": "585-385-6030",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLOMGREN",
        "first_name": "MARY",
        "credential": "CASAC. LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-24",
        "last_updated": "2023-01-25",
        "certification_date": "2023-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "27882",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "010099-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter H. Block, M.D.
• Robert Block, MD
• Brionna Morgan Blocker, RN
• Jallin Monique Blocker
• Renee Lynn Blodgett, LCAT
• Saige Blondell
• Christine Anne Blonski, D.O.
• Blonsky Family Chiropractic
• Deborah Marie Blonsky, MS
• Sara Blonsky, DC

• Mental Health Counselor in Rochester, NY
• Providers in Rochester, NY by specialty
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.