Amy M Blazawski, MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

006006 Issued in CT

Practice address

14 Grandview Ter
Vernon, CT 06066-3412

Phone

(860) 205-8793

NPI assigned

Nov 30, 2022

Sex

Female

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1669766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669766400000",
    "number": "1336859396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 GRANDVIEW TER",
            "city": "VERNON",
            "state": "CT",
            "postal_code": "060663412",
            "telephone_number": "860-205-8793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 GRANDVIEW TER",
            "city": "VERNON",
            "state": "CT",
            "postal_code": "060663412",
            "telephone_number": "860-205-8793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAZAWSKI",
        "first_name": "AMY",
        "middle_name": "M",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-30",
        "last_updated": "2022-11-30",
        "certification_date": "2022-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "006006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Courtney Marie Bergin
• Donna Delaney Bernard, RDN
• Kumeh Bestman, LCSW
• Beyond Wellness Healthcare PLLC
• Luke Anthony Blanco, D.C.
• Bloom Mindfully Counseling PLLC
• Allison Blunt
• Stacey Boisselle, LPC
• Vickie Boivin, PHARMD.
• Bolbol LLC

• All providers in Vernon, CT
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2022; 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.