Active NPI
Linda Frances Blum, PSYD
- Clinical Psychologist
- Montlcair, NJ
National Provider Identifier
1144288622
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 68:016344
- Practice address
- 101 Gordonhurst Ave.
Montlcair, NJ 07043 - Phone
- (516) 458-2921
- NPI assigned
- May 3, 2006
- Last updated
- Mar 20, 2017
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 68:016344 | NY | Primary |
Addresses
Primary practice location
101 Gordonhurst Ave.
Montlcair, NJ 07043
Mailing address
101 Gordonhurst Ave.
Montclair, NJ 07043-5000
Phone (516) 458-2921
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 68:016344 | NY | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| On-Site Psychological Services PC | Clinical | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Clinical Psychologist
- Ridgefield, CT
- NPI 1992807887
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146614400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1489968000000",
"number": "1144288622",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 GORDONHURST AVE.",
"city": "MONTCLAIR",
"state": "NJ",
"postal_code": "070435000",
"telephone_number": "516-458-2921"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 GORDONHURST AVE.",
"city": "MONTLCAIR",
"state": "NJ",
"postal_code": "07043",
"telephone_number": "516-458-2921"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLUM",
"first_name": "LINDA",
"middle_name": "FRANCES",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-05-03",
"last_updated": "2017-03-20",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "68:016344",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.