Whitney Stana Blakely, LCSW MSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

149015840 Issued in IL

Practice address

415 S Mulford Rd
Rockford, IL 61108-3011

Phone

(815) 979-8164

Fax

(815) 399-5767

NPI assigned

Apr 9, 2013

Last updated

Apr 9, 2013By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Clinical Social Worker

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Whitney S Blakely PC

  • Clinical Social Worker
  • Rockford, IL
  • NPI 1184378762
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1365465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365465600000",
    "number": "1831532803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 S MULFORD RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611083011",
            "telephone_number": "815-979-8164",
            "fax_number": "815-399-5767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 S MULFORD RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611083011",
            "telephone_number": "815-979-8164",
            "fax_number": "815-399-5767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKELY",
        "first_name": "WHITNEY",
        "middle_name": "STANA",
        "name_prefix": "Mrs.",
        "credential": "LCSW MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-09",
        "last_updated": "2013-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "149015840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thuy Nguyen Blair, PHARMD
• Constance Faye Blaisdell, NP
• Catherine L Blake, APN CNP
• Traci Leigh Blake, DNP,ACNPC-AG, CRNFA
• Bonnie Blakeley, L.C.P.C.
• Daniel Blanck, PT, DPT
• Deanne Blanco, OTR/L
• Rachel A Bland, CNM
• Carrie M. Blaser, APNP
• Jennifer Ann Blaser, PTA

• Social Worker in Rockford, IL
• Providers in Rockford, IL by specialty
• Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.