Christie Lee Blaylock, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904003316 Issued in VA

Practice address

14325 Jeffries PL
Midlothian, VA 23114-4359

Phone

(804) 409-2353

NPI assigned

Aug 27, 2007

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in VA

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 Social Worker

Education

Other, 1994

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Sondermind Provider Network LLCGroup PAC ID 9537572490, 1,295 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 and National Provider Directory roles.

• Sondermind Provider Network LLC

  • Clinical Social Worker
  • Denver, CO
  • NPI 1760854442

  VA

  Medicare reassignment Care Compare group NPD
• River City Counseling PLLC

  • Clinical Social Worker
  • Midlothian, VA
  • NPI 1750054359
  Medicare reassignment NPD
• Behavior & Stress Management Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Colonial Heights, VA
  • NPI 1649388075
  NPD (past)

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

{
    "created_epoch": "1188172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643932800000",
    "number": "1568655199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14325 JEFFRIES PL",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231144359",
            "telephone_number": "804-419-4122",
            "fax_number": "804-520-5650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14325 JEFFRIES PL",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231144359",
            "telephone_number": "804-409-2353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAYLOCK",
        "first_name": "CHRISTIE",
        "middle_name": "LEE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-27",
        "last_updated": "2022-02-04",
        "certification_date": "2022-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904003316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "christieblaylocklcsw@gmail.com",
            "affiliation": "N",
            "endpointDescription": "professional",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "14325 Jeffries Pl",
            "city": "Midlothian",
            "state": "VA",
            "country_code": "US",
            "postal_code": "231144359",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lindsey P Blake, DPT
• Michael Blake, DPT
• Peter Patrick Blakey, M.D.
• Marcus Thea Bland, M.ED,RBT
• Emily Blankinship, M.S.W., L.C.S.W.
• BLC Southerland Place - Midlothian, LLC
• Blessed Enterprises LLC
• Emma Blevins
• Carl M Block
• Heather Bloebaum Laramore, PHARMD

• Clinical Social Worker in Midlothian, VA
• Providers in Midlothian, VA by specialty
• Clinical Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2022; 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.