Phillip Francis Blea, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

3451 Issued in OR

Practice address

4455 NE Highway 20
Corvallis, OR 97330-9695

Phone

(541) 750-1110

NPI assigned

Jan 28, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mr. Phillip Francis Blea Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1169942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356497556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3570 ELDERBERRY DR S",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973024053",
            "telephone_number": "503-587-0555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4455 NE HIGHWAY 20",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973309695",
            "telephone_number": "541-750-1110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLEA",
        "first_name": "PHILLIP",
        "middle_name": "FRANCIS",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "3451",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW",
            "identifier": "TFS001CFH",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PHILLIP",
            "last_name": "BLEA",
            "middle_name": "FRANCIS",
            "prefix": "MR.",
            "credential": "LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Chad Anthony Blanchard
• David Howard Blatt, M.D.
• Diana Rebecca Blatt
• Miyuki Blatt
• Katy Lynne Blaustein
• Eric John Blickenstaff, L.C.S.W.
• Forrest Bliss, DO
• Katelyn Elizabeth Bliven
• Christopher Michael Bloom, CADC I
• James Blount

• Clinical Social Worker in Corvallis, OR
• Providers in Corvallis, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.