Katie A Blinn, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

121058 Issued in MA

Practice address

103 Commercial St
Brockton, MA 02302-3133

Phone

(508) 580-4691

NPI assigned

Jun 9, 2015

Last updated

Apr 28, 2021By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Dec 13, 2024 through Dec 13, 2026

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Richer Soil Counseling LLC

  • Clinical Social Worker
  • Boylston, MA
  • NPI 1447712575
  NPD (past)

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

{
    "created_epoch": "1433808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619568000000",
    "number": "1336529916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 COMMERCIAL ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023023101",
            "telephone_number": "508-521-1020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 COMMERCIAL ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023023133",
            "telephone_number": "508-580-4691"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15 Prospect St",
            "address_purpose": "LOCATION",
            "city": "Nashua",
            "state": "NH",
            "postal_code": "030603923",
            "country_code": "US",
            "telephone_number": "603-889-6147",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLINN",
        "first_name": "KATIE",
        "middle_name": "A",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-09",
        "last_updated": "2021-04-28",
        "certification_date": "2021-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "121058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nadine Blanchett, NP
• Michael Blandon
• Kirsten Lea Blaney
• Dana L Blanks, RN,CPNP
• John P Blatz Jr., DDS
• Sebastian James Bliss, PHD
• Sarah Beth Blodgett, LCSW 225289
• Brooke J Bloom, M.D.
• Dana Paul Boardman, KINESIOTHERAPIST
• Rebekah Michelle Boateng

• Clinical Social Worker in Brockton, MA
• Providers in Brockton, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.