Active NPI
Steven Mark Blazing Jr., BS, LSW
- Social Worker
- Maplewood, MN
National Provider Identifier
1770017923
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 24322
- Practice address
- 2055 White Bear Ave N
Maplewood, MN 55109-3716 - Phone
- (651) 289-1202
- Fax
- (651) 289-9900
- NPI assigned
- Apr 14, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 24322 | MN | Primary |
Addresses
Primary practice location
2055 White Bear Ave N
Maplewood, MN 55109-3716
Mailing address
2055 White Bear Ave N
Maplewood, MN 55109-3716
Phone (507) 519-0755
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Bachelor of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24322 | MN | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1492128000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1492128000000",
"number": "1770017923",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2055 WHITE BEAR AVE N",
"city": "MAPLEWOOD",
"state": "MN",
"postal_code": "551093716",
"telephone_number": "507-519-0755",
"fax_number": "651-289-9900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2055 WHITE BEAR AVE N",
"city": "MAPLEWOOD",
"state": "MN",
"postal_code": "551093716",
"telephone_number": "651-289-1202",
"fax_number": "651-289-9900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLAZING",
"first_name": "STEVEN",
"middle_name": "MARK",
"name_suffix": "Jr.",
"credential": "BS, LSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-04-14",
"last_updated": "2017-04-14",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MN",
"license": "24322",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Maplewood, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.