Colleen Blyskal, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

097042 Issued in NY

Practice address

100 Hicksville Rd Ste 203
Massapequa, NY 11758-5823

Phone

(516) 242-6183

NPI assigned

May 6, 2021

Last updated

Sep 16, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

State licenses

Practice roles

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.

• Lager LCSW, PC

  • Clinical Social Worker
  • Wantagh, NY
  • NPI 1194291773

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1620259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726444800000",
    "number": "1437733490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 CROWELL PL",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115804019",
            "telephone_number": "516-242-6183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HICKSVILLE RD STE 203",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117585823",
            "telephone_number": "516-242-6183"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20 Hicksville Rd",
            "address_purpose": "LOCATION",
            "city": "Massapequa",
            "state": "NY",
            "postal_code": "117585819",
            "country_code": "US",
            "telephone_number": "516-242-6183",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLYSKAL",
        "first_name": "COLLEEN",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-06",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "097042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Greg Ross Blair
• Sheldon P Blau, MD
• Beth Heather Bloom, R.D.
• Blue Sky Family Health Nurse Practitioner PLLC
• Mordecai Bluth, M.D.
• Diana Bocina
• Elizabeth Bock
• Stephanie Carmela Boegle
• Tyler Boening, OTR/L
• Maxine Ann Bogen, MA CCC-SLP

• Social Worker in Massapequa, NY
• Providers in Massapequa, NY by specialty
• Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2024; 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.