Active NPI
Amanda Blossom, QMHS, LSW
- Social Worker
- Toledo, OH
National Provider Identifier
1780188284
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- S.2513079
- Practice address
- 1776 Tremainsville Rd
Toledo, OH 43613-4039 - Phone
- (419) 214-0606
- NPI assigned
- Mar 20, 2018
- Sex
- Female
- Sole proprietor
- Yes
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 | S.2513079 | OH | Primary |
Addresses
Primary practice location
1776 Tremainsville Rd
Toledo, OH 43613-4039
Mailing address
885 Commerce Dr
Perrysburg, OH 43551-5267
Phone (419) 330-5122
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S.2513079 | OH | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| A Renewed Mind | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- Toledo, OH
- NPI 1760749444
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1521504000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1778457600000",
"number": "1780188284",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "885 COMMERCE DR",
"city": "PERRYSBURG",
"state": "OH",
"postal_code": "435515267",
"telephone_number": "419-330-5122",
"fax_number": "419-931-6820"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1776 TREMAINSVILLE RD",
"city": "TOLEDO",
"state": "OH",
"postal_code": "436134039",
"telephone_number": "419-214-0606"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLOSSOM",
"first_name": "AMANDA",
"name_prefix": "Miss",
"credential": "QMHS, LSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-03-20",
"last_updated": "2026-05-11",
"certification_date": "2026-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "OH",
"license": "S.2513079",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Toledo, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.