Emily Blazic, LMSW, AASW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

65 S Main St Ste a
Rockford, MI 49341-1287

Phone

(616) 805-3660

Fax

(616) 805-3631

NPI assigned

Jan 24, 2008

Last updated

Mar 20, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Emily Nieuwsma Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Counseling Center of West Michigan, LLC

  • Mental Health Counselor
  • Grand Rapids, MI
  • NPI 1437610730
  NPD
• Virtuwell Therapy, LLC

  • Mental Health Counselor
  • Grand Rapids, MI
  • NPI 1871356212
  NPD
• County of Clackamas Office of County Auditor

  dba Hilltop Behavioral Health Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Milwaukie, OR
  • NPI 1245269315
  NPD (past)

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

{
    "created_epoch": "1201132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679270400000",
    "number": "1306023064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 BRIDGE ST NW STE 1120",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495045356",
            "telephone_number": "616-805-3660",
            "fax_number": "616-805-3631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 S MAIN ST STE A",
            "city": "ROCKFORD",
            "state": "MI",
            "postal_code": "493411287",
            "telephone_number": "616-805-3660",
            "fax_number": "616-805-3631"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "998 Library Ct",
            "address_purpose": "LOCATION",
            "city": "Oregon City",
            "state": "OR",
            "postal_code": "970454041",
            "country_code": "US",
            "telephone_number": "503-722-6584",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLAZIC",
        "first_name": "EMILY",
        "name_prefix": "Mrs.",
        "credential": "LMSW, AASW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-24",
        "last_updated": "2023-03-20",
        "certification_date": "2023-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "NIEUWSMA",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Peter J Birkeland, PHD
• Stephanie Bisson
• Nicole Blake-Jones
• Amanda Marie Blandford, ND
• Rebecca Blasen, LMSW
• Erin L Bloomquist, P.T.
• Nathaniel Bobb
• Karen Jo Boden, PT
• Jeanne Bolle, M.S., L.L.P.
• Elise Olivia Bolthouse

• Clinical Social Worker in Rockford, MI
• Providers in Rockford, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2023; 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.