Connie Lynn Blizzard, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

04883 Issued in MD

Practice address

10025 Governor Warfield Pkwy Ste 202
Columbia, MD 21044-3329

Phone

(443) 201-1807

NPI assigned

Sep 13, 2007

Last updated

Jul 26, 2023By 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

Enrolled in MD

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Warr Family Group LLCGroup PAC ID 4880042415, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Warr Family Group LLC

  dba Ellie Mental Health of Columbia

  • Mental Health Counselor
  • Columbia, MD
  • NPI 1205546165
  Medicare reassignment Care Compare group NPD
• Shatter Health, LLC

  dba Ellie Georgetown

  • Clinical Social Worker
  • Washington, DC
  • NPI 1407748890
  NPD

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

{
    "created_epoch": "1189641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690329600000",
    "number": "1417142290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1970 OLD WESTMINSTER PIKE",
            "city": "FINKSBURG",
            "state": "MD",
            "postal_code": "210481331",
            "telephone_number": "443-462-0056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10025 GOVERNOR WARFIELD PKWY STE 202",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210443329",
            "telephone_number": "443-201-1807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLIZZARD",
        "first_name": "CONNIE",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-13",
        "last_updated": "2023-07-26",
        "certification_date": "2023-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "04883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lila Blanchard
• Jasmine Jessica Blanco Ventura
• Valerie Lynn Blanke, RN
• Marie-Gabrielle Blassou
• Gary Blechman, M.D.
• Arnold Stanley Block, P.HD
• Christine Marie Bloom, R.N.
• Darlene Ruth Bloom, OTR/L
• Helen Kappler Bloom
• Matthew Bloom, DPT

• Clinical Psychologist in Columbia, MD
• Providers in Columbia, MD by specialty
• Clinical Psychologist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.