Edward Boris Blyther, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C020027 Issued in NC

Practice address

615 Shipyard Blvd
Wilmington, NC 28412-6431

Phone

(910) 343-0145

Fax

(910) 341-5779

NPI assigned

Nov 9, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Coastal Horizons Center, Inc.

  • Community/Behavioral Health Agency
  • Wilmington, NC
  • NPI 1831333467
  NPD (past)

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

{
    "created_epoch": "1699488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779926400000",
    "number": "1043084114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 SHIPYARD BLVD",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284126431",
            "telephone_number": "910-343-0145",
            "fax_number": "910-341-5779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 SHIPYARD BLVD",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284126431",
            "telephone_number": "910-343-0145",
            "fax_number": "910-341-5779"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "330 Shipyard Blvd",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284121837",
            "country_code": "US",
            "telephone_number": "919-515-4081",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "309 Progress Dr",
            "address_purpose": "LOCATION",
            "city": "Burgaw",
            "state": "NC",
            "postal_code": "284253280",
            "country_code": "US",
            "telephone_number": "910-259-0668",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLYTHER",
        "first_name": "EDWARD",
        "middle_name": "BORIS",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-11-09",
        "last_updated": "2026-05-28",
        "certification_date": "2026-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C020027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blue Lotus Counseling, PLLC
• Blue Telepsych Urgent Care (Blue PsychCare)
• Tony Blue, MD
• Bluewater Surgical, PLLC
• Zachary Allen Blumenkehl
• Nolan Bodah, D.D.S.
• John Herman Bode, P.A.
• Body Innovations Physical Therapy & Wellness LLC
• Bodytech Acupuncture
• Bodytherapy, Inc. (Change The Game Performance Therapy)

• Clinical Social Worker in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.