Blair Ambrose, MSW

Individual provider Active NPI Clinical Social Worker · Concord, NH

NPI 1659424182 · NPPES record last updated Dec 4, 2007

Key facts

NPI
1659424182
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
1398 (NH)
Practice address
278 Pleasant St
Concord, NH 03301-2551
Phone
(603) 226-0817
NPI assigned
Jan 19, 2007
Sex
Female
Sole proprietor
No

Organizations & group practices 1

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.

Medicare Care Compare profile

Specialty
Clinical Social Worker
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1802 Elm St
Suite 8
Manchester, NH 03104-2948
Phone (603) 491-8208

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NH
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20080215000627 NH Practitioner - Clinical Social Worker 2567545387 Practice locations: Manchester, NH

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
1398NHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Evolve Counseling & Training LLC Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 1398 NH Yes

Addresses

Primary practice location

278 Pleasant St
Concord, NH 03301-2551

Mailing address

PO Box 2032
Concord, NH 03302-2032
Phone (603) 226-7570

Other providers in Concord, NH

All providers in Concord, NH · Clinical Social Worker in New Hampshire

Sources for this page

Verify at the official NPI Registry.