Individual provider Active NPI

Jessica Blehm, LSCSW

  • Clinical Social Worker
  • Great Bend, KS
National Provider Identifier
1750770210
Registry record updated Jun 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
4685 Issued in KS
Practice address
5815 Broadway Ave
Great Bend, KS 67530-3123
Phone
(620) 792-2544
Fax
(620) 792-7052
NPI assigned
Jan 21, 2015
Last updated
Jun 24, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 076 KS
Clinical Social Worker 1041C0700X 4685 KS Primary

Addresses

Primary practice location

5815 Broadway Ave
Great Bend, KS 67530-3123

Mailing address

5815 Broadway Ave
Great Bend, KS 67530-3123
Phone (620) 792-2544

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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

Enrollment IDStateProvider typePAC IDDetails
I20241112002433 KS Practitioner - Clinical Social Worker 4385178466 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Center for Counseling and ConsultationGroup PAC ID 2961458518, 14 clinicians

Practice addresses (Care Compare)

5815 Broadway Ave
Great Bend, KS 67530-3123
Phone (620) 792-2544

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
076KSMDAddiction (Substance Use Disorder) Counselor
4685KSMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Counseling and Consultation CurrentSince Aug 26, 2024 Accepting new patients
Pawnee Mental Health Service, Inc. Past Accepting new patients

Locations

5815 Broadway Ave
Great Bend, KS 67530
Phone (620) 792-2544

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1421798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719187200000",
    "number": "1750770210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5815 BROADWAY AVE",
            "city": "GREAT BEND",
            "state": "KS",
            "postal_code": "675303123",
            "telephone_number": "620-792-2544",
            "fax_number": "620-792-7052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5815 BROADWAY AVE",
            "city": "GREAT BEND",
            "state": "KS",
            "postal_code": "675303123",
            "telephone_number": "620-792-2544",
            "fax_number": "620-792-7052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLEHM",
        "first_name": "JESSICA",
        "name_prefix": "Ms.",
        "credential": "LSCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-21",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "KS",
            "license": "076",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KS",
            "license": "4685",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Bend, KS

Sources for this page

Verify at the official NPI Registry.