Organization Active NPI

Blair Counseling Services

  • Clinical Social Worker
  • Syracuse, NY
National Provider Identifier
1275251217
Registry record updated Aug 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
BLAIR COUNSELING SERVICES
Practice address
2112 Erie Blvd E
Syracuse, NY 13224-1041
Phone
(315) 813-7062
Fax
(315) 813-7067
NPI assigned
Aug 16, 2022
Last updated
Aug 16, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2022

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

Authorized official

Name
Mr. David Allen Blair, LCSW-RNPI 1114075884
Title
Owner
Phone
(315) 813-7062

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

2112 Erie Blvd E
Syracuse, NY 13224-1041

Mailing address

2112 Erie Blvd E
Syracuse, NY 13224-1041
Phone (315) 813-7062

Other identifiers 2

IdentifierTypeStateIssuer
22267OtherNYLICENSE NUMBER
5193719565OtherPECOS I.D.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230307002214 NY Part B Supplier - Clinic/Group Practice 5799158051 Receives reassigned benefits from 5 practitioners
Practice locations: Syracuse, NY

National Provider Directory

National Provider Directory

Locations

2112 Erie Blvd E
Syracuse, NY 13224
Phone (315) 813-7062

6493 Ridings Rd
Ste 115
Syracuse, NY 13206
Phone (315) 813-7062

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1660608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660608000000",
    "number": "1275251217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2112 ERIE BLVD E",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132241041",
            "telephone_number": "315-813-7062",
            "fax_number": "315-813-7067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2112 ERIE BLVD E",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132241041",
            "telephone_number": "315-813-7062",
            "fax_number": "315-813-7067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLAIR COUNSELING SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-16",
        "last_updated": "2022-08-16",
        "certification_date": "2022-08-09",
        "status": "A",
        "authorized_official_last_name": "BLAIR",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "315-813-7062",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW-R"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "22267",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PECOS I.D.",
            "identifier": "5193719565",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.