Active NPI
Tamika Xenia Blaisdell
- Clinical Social Worker
- Marion, MT
National Provider Identifier
1528475365
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 28856
- Practice address
- 9285 Lost Prairie Road
Marion, MT 59925 - Phone
- (406) 407-0750
- NPI assigned
- Jul 14, 2014
- Last updated
- Oct 18, 2023
- Sex
- Female
- Sole proprietor
- Yes
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 | 28856 | CA | Primary |
Addresses
Primary practice location
9285 Lost Prairie Road
Marion, MT 59925
Mailing address
432 E Idaho St Ste 430
Kalispell, MT 59901-4137
Phone (406) 407-0750
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 |
|---|---|---|---|
| 28856 | CA | MD | Pharmacotherapy Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1405296000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1697587200000",
"number": "1528475365",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "432 E IDAHO ST STE 430",
"city": "KALISPELL",
"state": "MT",
"postal_code": "599014137",
"telephone_number": "406-407-0750"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9285 LOST PRAIRIE ROAD",
"city": "MARION",
"state": "MT",
"postal_code": "59925",
"telephone_number": "406-407-0750"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLAISDELL",
"first_name": "TAMIKA",
"middle_name": "XENIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-07-14",
"last_updated": "2023-10-18",
"certification_date": "2023-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "28856",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marion, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 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.