Gregory George Blakley, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

10865 Issued in CT

Practice address

1 Long Wharf Dr Ste 321
New Haven, CT 06511-5946

Phone

(203) 781-4600

Fax

(203) 781-4624

NPI assigned

Nov 21, 2019

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

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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.

• Synaptic Communications

  • Clinical Social Worker
  • Bridgeport, CT
  • NPI 1225647597
  NPD Authorized official

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

{
    "created_epoch": "1574294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642982400000",
    "number": "1538705827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 LONG WHARF DR STE 321",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065115946",
            "telephone_number": "203-781-4600",
            "fax_number": "203-781-4624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 LONG WHARF DR STE 321",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065115946",
            "telephone_number": "203-781-4600",
            "fax_number": "203-781-4624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKLEY",
        "first_name": "GREGORY",
        "middle_name": "GEORGE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-11-21",
        "last_updated": "2022-01-24",
        "certification_date": "2022-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "10865",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008003745",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004041000",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008092064",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katherine Anne Blackwell
• Tecshana Nicola Blackwood, PA
• Caitlin Blair
• Phillipa Blake, MSW
• Robert Tyler Blakes, MD, MBA
• Jermaine Blakley
• Shelby Blalock
• Audrey Anderson Blanchard, LCSW
• Mark Andrew Blanchard
• Alex Edward Blanchette, MD

• Clinical Social Worker in New Haven, CT
• Providers in New Haven, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2022; 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.