Active NPI
Cheryl Lynne Blossom, MSW
- Clinical Social Worker
- Albuquerque, NM
National Provider Identifier
1437217874
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- I-3495
- Practice address
- 2420 Juan Tabo Blvd NE
Albuquerque, NM 87112-1818 - Phone
- (505) 292-2237
- Fax
- (505) 830-6527
- NPI assigned
- Dec 5, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | I-3495 | NM | Primary |
Addresses
Primary practice location
2420 Juan Tabo Blvd NE
Albuquerque, NM 87112-1818
Mailing address
3409-D Lafayette Dr. NE
Albuquerque, NM 87107
Phone (505) 250-6723
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 51786826 | Medicaid | NM |
Other names 1
- Cheryl Bell Silas
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| I-3495 | NM | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165276800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1272585600000",
"number": "1437217874",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3409-D LAFAYETTE DR. NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "87107",
"telephone_number": "505-250-6723"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2420 JUAN TABO BLVD NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871121818",
"telephone_number": "505-292-2237",
"fax_number": "505-830-6527"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLOSSOM",
"first_name": "CHERYL",
"middle_name": "LYNNE",
"credential": "MSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-05",
"last_updated": "2010-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NM",
"license": "I-3495",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "51786826",
"state": "NM"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "CHERYL",
"last_name": "SILAS",
"middle_name": "BELL",
"credential": "MSW",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.