Scott M Blaisdell, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCS17400 Issued in CA

Practice address

3817 Linden Ave
Long Beach, CA 90807-3414

Phone

(562) 883-1516

NPI assigned

May 31, 2008

Sex

Male

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

Enrolled in CA

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

State University of New York at Stony Brook, School of Medicine, 1989

Medicare assignment

May accept Medicare assignment

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.

• Healthcare in Action Medical Group

  • Internal Medicine Physician
  • Long Beach, CA
  • NPI 1881360758
  Medicare reassignment NPD

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

{
    "created_epoch": "1212192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212192000000",
    "number": "1750549283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3817 LINDEN AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908073414",
            "telephone_number": "562-883-1516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3817 LINDEN AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908073414",
            "telephone_number": "562-883-1516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAISDELL",
        "first_name": "SCOTT",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-31",
        "last_updated": "2008-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS17400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roger Blackshear
• Heather Blackshire
• Antoinette Blackstock, RN
• Rachel E Blaine, DSC, MPH, RDN
• Frank Clarence Blair III, DDS
• Emily Lorraine Blake
• John L. Blake, D.D.S.
• Patricia Blake
• Imani Blalock
• Michael Blam, MD

• Clinical Social Worker in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2008; 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.