Samuel Blickle

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

116645 Issued in CA

Practice address

982 Mission St
San Francisco, CA 94103-2911

Phone

(415) 597-4958

NPI assigned

Aug 7, 2018

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1533600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693353600000",
    "number": "1407335870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "982 MISSION ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941032911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "982 MISSION ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941032911",
            "telephone_number": "415-597-4958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLICKLE",
        "first_name": "SAMUEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-07",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "116645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blende Dental Corporation
• David M. Blende, DDS
• Ciara Margaret Blessing, CCC-SLP
• Lewis Stuart Blevins Jr., MD
• Inna Bleykhman, M.S.W.
• Jill Blickley, DO
• Joseph Nathan Blinder
• Robert Carter Blink, M.D.
• Bliss in Being Family Therapy
• Donald Christopher Bliss, LCSW

• Clinical Social Worker in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Clinical Social Worker in California

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