Mary Ann Bilotta Blackman

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

1026994 Issued in MA

Practice address

122 Granite St
Leominster, MA 01453-2504

Phone

(978) 534-7735

Fax

(978) 534-1765

NPI assigned

Dec 16, 2018

Sex

Female

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 16, 2018.

{
    "created_epoch": "1544918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544918400000",
    "number": "1194296350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 GRANITE ST",
            "city": "LEOMINSTER",
            "state": "MA",
            "postal_code": "014532504",
            "telephone_number": "978-534-7735",
            "fax_number": "978-534-1765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 GRANITE ST",
            "city": "LEOMINSTER",
            "state": "MA",
            "postal_code": "014532504",
            "telephone_number": "978-534-7735",
            "fax_number": "978-534-1765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BILOTTA BLACKMAN",
        "first_name": "MARY",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-16",
        "last_updated": "2018-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1026994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Leominster, MA
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.