Theresa Flannery-Blachura, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LC11557 Issued in ME

Practice address

11 Mill St
Houlton, ME 04730-1877

Phone

(207) 532-6523

Fax

(207) 532-3873

NPI assigned

Mar 26, 2007

Last updated

May 29, 2008By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ME

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2005

Medicare assignment

May accept Medicare assignment

Group practices

Northern Lighthouse IncGroup PAC ID 2769611805, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Northern Lighthouse Inc.

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Mars Hill, ME
  • NPI 1831311968
  Medicare reassignment Care Compare group
• Caribou Eyecare, P.a.

  • Optometrist
  • Caribou, ME
  • NPI 1356470645
  NPD (past)

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212019200000",
    "number": "1154448785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 MILL ST",
            "city": "HOULTON",
            "state": "ME",
            "postal_code": "047301877",
            "telephone_number": "207-532-6523",
            "fax_number": "207-532-3873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 MILL ST",
            "city": "HOULTON",
            "state": "ME",
            "postal_code": "047301877",
            "telephone_number": "207-532-6523",
            "fax_number": "207-532-3873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLANNERY-BLACHURA",
        "first_name": "THERESA",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-26",
        "last_updated": "2008-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC11557",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAINE CARE NUMBER",
            "identifier": "432024199",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Arthur Fasulo, LCSW
• Judith E. Feibus, LCSW
• Lisa Ann Findlater
• Amanda Nicole Saucier Fitzpatrick, DPT
• Serenna J Fitzpatrick, PTA, LMT
• Lois M Flewelling, LCPC
• Melissa Sue Flewelling, LCPC
• Alexander Ricky Folsom, PTA, ATC
• Colleen P Folsom, RN
• Lorraine Folsom, DPT

• Clinical Social Worker in Houlton, ME
• Providers in Houlton, ME by specialty
• Clinical Social Worker in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2008; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.