Mary Louise Blankenburg, LISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

01283 Issued in IA

Practice address

20 S Van Buren St
Iowa City, IA 52240-1821

Phone

(319) 400-2268

NPI assigned

Jul 27, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Ms. Lou Blankenburg Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

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.

• Counseling and Health Center LLP

  • Mental Health Counselor
  • Iowa City, IA
  • NPI 1437120573
  NPD

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1104840347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1073",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522441073",
            "telephone_number": "319-400-2268",
            "fax_number": "319-354-1679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 S VAN BUREN ST",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522401821",
            "telephone_number": "319-400-2268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANKENBURG",
        "first_name": "MARY",
        "middle_name": "LOUISE",
        "name_prefix": "Ms.",
        "credential": "LISW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-27",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "01283",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0272708",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK/BCBS",
            "identifier": "23547",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "250553000",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LOU",
            "last_name": "BLANKENBURG",
            "prefix": "MS.",
            "credential": "LISW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Nathan Michael Blair, M.D.
• Robert Alvin Blair, D.D.S.
• William F Blair, M.D.
• Hunter Jackson Blalock
• Gabriella Maria Blanchard-Manning, LISW
• Kayla Danielle Blankenship
• Daniel Blatt
• John L Blau, MD
• Austin K Blay, CRNA
• Danubio E Blen, D.D.S

• Clinical Social Worker in Iowa City, IA
• Providers in Iowa City, IA by specialty
• Clinical Social Worker in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.