Holley Reilly Blitz, MA MFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

LMFT-8097 Issued in ID

Practice address

4750 N Five Mile Rd
Boise, ID 83713-2715

Phone

(208) 996-0931

NPI assigned

Sep 16, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Mrs. C Holley Blitz Professional name

Medicare fee-for-service enrollment

Enrolled in ID

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

Marriage and Family Therapist

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Valley Behavioral Health IncorporatedGroup PAC ID 0042121196, 84 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

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.

• Valley Behavioral Health Incorporated

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • West Valley City, UT
  • NPI 1932166980

  ID, Marriage & Family Therapist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692230400000",
    "number": "1255437950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4750 NORTH MILE ROAD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "83713",
            "telephone_number": "208-996-0932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4750 N FIVE MILE RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837132715",
            "telephone_number": "208-996-0931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLITZ",
        "first_name": "HOLLEY",
        "middle_name": "REILLY",
        "name_prefix": "Ms.",
        "credential": "MA MFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-16",
        "last_updated": "2023-08-17",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFT33818",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "ID",
            "license": "LMFT-8097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "C",
            "last_name": "BLITZ",
            "middle_name": "HOLLEY",
            "prefix": "MRS.",
            "credential": "MA MFT",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Nicholas Blickenstaff, M.D., M.S.
• Richard Dale Blickenstaff, M.D.
• Blink RX LLC
• Natasha Megan Blinn, PH.D.
• Mitchell Andrew Bliss, PA
• Carolyn Block, MSPT
• Kelly Lauren Block, DO
• Brittany Blockman, MD
• Grayson Blom, D.C.
• Heidi Rae Blomberg, LMSW

• All providers in Boise, ID
• Marriage & Family Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2023; 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.