Danielle Blyden, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW17682 Issued in FL

Practice address

16506 N Dale Mabry Hwy
Tampa, FL 33618-1325

Phone

(813) 262-0460

NPI assigned

Dec 3, 2020

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

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.

• Bloom Counseling and Therapeutic Services

  • Clinical Social Worker
  • Tampa, FL
  • NPI 1376148601
  NPD Authorized official

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

{
    "created_epoch": "1606953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606953600000",
    "number": "1740885193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12011 CITRUS FALLS CIR APT 203",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336255716",
            "telephone_number": "407-455-4425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16506 N DALE MABRY HWY",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336181325",
            "telephone_number": "813-262-0460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLYDEN",
        "first_name": "DANIELLE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-03",
        "last_updated": "2020-12-03",
        "certification_date": "2020-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW17682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bluestone VBC FL LLC
• Betsy Karen Blum, LCMHC
• Jessica Blunt
• Steven M Blustein, D.P.M.
• Jennifer Bly
• Paige Blydenburgh, SLP
• Stefanie Blythe, DPT
• Wilson Omar Boada
• Boardprep, LLC
• Beverly Boas

• Clinical Social Worker in Tampa, FL
• Providers in Tampa, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2020; 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.