Active NPI
Lindsey Blaivas, LCSW
- Social Worker
- Westport, CT
National Provider Identifier
1104420306
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 5487
- Practice address
- 50 Riverside Ave
Westport, CT 06880-4242 - Phone
- (917) 232-7605
- NPI assigned
- Nov 28, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 13307 | CT | |
| Social Worker | 104100000X | 5487 | CT | Primary |
Addresses
Primary practice location
50 Riverside Ave
Westport, CT 06880-4242
Mailing address
36 Hyde LN
Westport, CT 06880-3916
Phone (917) 232-7605
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 |
|---|---|---|---|
| 5487 | CT | MD | Social Worker |
| 13307 | CT | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1606521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726704000000",
"number": "1104420306",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "36 HYDE LN",
"city": "WESTPORT",
"state": "CT",
"postal_code": "068803916",
"telephone_number": "917-232-7605"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "50 RIVERSIDE AVE",
"city": "WESTPORT",
"state": "CT",
"postal_code": "068804242",
"telephone_number": "917-232-7605"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLAIVAS",
"first_name": "LINDSEY",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-11-28",
"last_updated": "2024-09-19",
"certification_date": "2024-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CT",
"license": "13307",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Social Worker",
"state": "CT",
"license": "5487",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Westport, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.