Active NPI
Amy M Blaskiewicz, LMHC
- Mental Health Counselor
- Indianapolis, IN
National Provider Identifier
1053445940
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 39000582
- Practice address
- 7526 E 82ND St
Suite 150
Indianapolis, IN 46256-1461 - Phone
- (317) 585-1060
- NPI assigned
- Mar 15, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 39000582 | IN | Primary |
Addresses
Primary practice location
7526 E 82ND St
Suite 150
Indianapolis, IN 46256-1461
Mailing address
11904 Laurel Oaks Dr
Indianapolis, IN 46236-3711
Phone (317) 823-6712
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 39000582 | IN | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Counseling Associates | Mental Health | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173916800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1053445940",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11904 LAUREL OAKS DR",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462363711",
"telephone_number": "317-823-6712"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7526 E 82ND ST",
"address_2": "SUITE 150",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462561461",
"telephone_number": "317-585-1060"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLASKIEWICZ",
"first_name": "AMY",
"middle_name": "M",
"credential": "LMHC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IN",
"license": "39000582",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.