Elijah Benjamin Blase, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

33354 Issued in MN

Practice address

2213 W 54TH St
Minneapolis, MN 55419-1515

Phone

(847) 477-9964

NPI assigned

Dec 17, 2024

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

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.

• Blase Therapy Solutions

  • Clinical Social Worker
  • Minneapolis, MN
  • NPI 1528861739
  NPD Authorized official

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

{
    "created_epoch": "1734393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734393600000",
    "number": "1750198248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3640 43RD AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554062823",
            "telephone_number": "847-477-9964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2213 W 54TH ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554191515",
            "telephone_number": "847-477-9964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLASE",
        "first_name": "ELIJAH",
        "middle_name": "BENJAMIN",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-12-17",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "33354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen Ann Blanchard, RD
• Kaylee Rose Blanchette, LICSW
• Roberto Carlos Blanco Duarte, MD
• Dylan Blank, DNP, APRN, CRNA
• Blase Therapy Solutions
• Erin Blase, LICSW
• Joelle Blasig, PHARMD
• John Blaska, L.AC.
• Elizabeth Blattner
• Julie Blatz, MSW, LICSW

• Clinical Social Worker in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2024; 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.