Individual provider Active NPI

Dalys Ann Blair, LICSW

  • Clinical Social Worker
  • Quincy, MA
National Provider Identifier
1841229606
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
859 Willard St
Suite 430
Quincy, MA 02169-7482
Phone
(617) 847-1924
NPI assigned
Jul 2, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X MA Primary

Addresses

Primary practice location

859 Willard St
Suite 430
Quincy, MA 02169-7482

Mailing address

859 Willard St
Suite 430
Quincy, MA 02169-7482
Phone (617) 847-1924

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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

Enrollment IDStateProvider typePAC IDDetails
I20060731000388 MA Practitioner - Clinical Social Worker 9032122544 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
886407682MAMDClinical Social Worker
212230MAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Shore Mental Health Center, Inc. CurrentSince Oct 17, 2010 Accepting new patients

Locations

1501 Washington St
Braintree, MA 02184
Phone (617) 745-2709

859 Willard St
Ste 430
Quincy, MA 02169
Phone (617) 847-1909

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1151798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1841229606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "859 WILLARD ST",
            "address_2": "SUITE 430",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021697482",
            "telephone_number": "617-847-1924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "859 WILLARD ST",
            "address_2": "SUITE 430",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021697482",
            "telephone_number": "617-847-1924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAIR",
        "first_name": "DALYS",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, MA

Sources for this page

Verify at the official NPI Registry.