George Leo Blandford
Individual provider Active NPI Clinical Social Worker · Wellfleet, MA
NPI 1790029601 · NPPES record last updated Jul 24, 2026
Key facts
- NPI
- 1790029601
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- LICSW120994 (MA)
- Practice address
- 2700 State Highway, Route 6
Unit 2
Wellfleet, MA 02667 - Phone
- (508) 905-2434
- Fax
- (508) 905-2855
- NPI assigned
- Nov 15, 2012
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180604001846 | MA | Practitioner - Clinical Social Worker | 4789949249 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 120994 | MA | MD | Clinical Social Worker |
| 221172 | MA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Justice Resource Institute | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 221172 | MA | |
| Clinical Social Worker | 1041C0700X | LICSW120994 | MA | Yes |
Addresses
Primary practice location
2700 State Highway, Route 6
Unit 2
Wellfleet, MA 02667
Mailing address
PO Box 2796
Orleans, MA 02653-6796
Phone (508) 905-2434
Other practice location 1
3130 State Hwy Rte 6
Wellfleet, MA 02667-7402
Phone (508) 349-3131
Other practice location 2
49 Harry Kemp Way
Provincetown, MA 02657-1618
Phone (508) 487-9395
Other practice location 3
710 Route 28
Harwich Port, MA 02646-1931
Phone (508) 432-1400
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110129621A | Medicaid | MA |
Other providers in Wellfleet, MA
- Susan M Baumgarten
- Rachel Bramson
- Matthew Burdette
- Laura E Cappello
- Compass Points Home Health Care LLC
- Marvin B Corlette
All providers in Wellfleet, MA · Clinical Social Worker in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 24, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.