Individual provider Active NPI

Yvon P Blaise, MSW

  • Clinical Social Worker
  • Pembroke Pines, FL
National Provider Identifier
1386188431
Registry record updated Dec 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
1000 N Hiatus Rd Ste 161
Pembroke Pines, FL 33026-3097
Phone
(954) 333-8787
NPI assigned
Dec 8, 2016
Last updated
Dec 8, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X NY Primary

Addresses

Primary practice location

1000 N Hiatus Rd Ste 161
Pembroke Pines, FL 33026-3097

Mailing address

5220 Rising Comet LN
Greenacres, FL 33463-5925
Phone (954) 770-1645

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1481155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481155200000",
    "number": "1386188431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5220 RISING COMET LN",
            "city": "GREENACRES",
            "state": "FL",
            "postal_code": "334635925",
            "telephone_number": "954-770-1645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 N HIATUS RD STE 161",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330263097",
            "telephone_number": "954-333-8787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAISE",
        "first_name": "YVON",
        "middle_name": "P",
        "name_prefix": "Mr.",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-12-08",
        "last_updated": "2016-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2016; 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.