Active NPI
Andrew Blum, MSW
- Clinical Social Worker
- Dallas, TX
National Provider Identifier
1821684523
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 101858
- Practice address
- 4500 S Lancaster Rd
Dallas, TX 75216-7167 - Phone
- (214) 857-3166
- Fax
- (214) 462-4831
- NPI assigned
- Dec 16, 2020
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 11821 | TN | |
| Clinical Social Worker | 1041C0700X | 101858 | CA | Primary |
Addresses
Primary practice location
4500 S Lancaster Rd
Dallas, TX 75216-7167
Mailing address
4500 S Lancaster Rd
Dallas, TX 75216-7167
Phone (214) 854-3166
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 |
|---|---|---|---|
| 101858 | CA | MD | Dentist |
| 11821 | TN | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1608076800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1734480000000",
"number": "1821684523",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4500 S LANCASTER RD",
"city": "DALLAS",
"state": "TX",
"postal_code": "752167167",
"telephone_number": "214-854-3166",
"fax_number": "214-462-4831"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4500 S LANCASTER RD",
"city": "DALLAS",
"state": "TX",
"postal_code": "752167167",
"telephone_number": "214-857-3166",
"fax_number": "214-462-4831"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLUM",
"first_name": "ANDREW",
"credential": "MSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-12-16",
"last_updated": "2024-12-18",
"certification_date": "2024-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "TN",
"license": "11821",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "101858",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.