De-Andrea Blaylock-Solar, MSW, LCSW, CST

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2010006307 Issued in MO

Practice address

9666 Olive Blvd Ste 330
Saint Louis, MO 63132-3035

Phone

(314) 877-8510

NPI assigned

Apr 20, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. De-Andrea Leslie Blaylock-Johnson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1271721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683590400000",
    "number": "1861718520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9666 OLIVE BLVD STE 330",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631323035",
            "telephone_number": "314-877-8510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9666 OLIVE BLVD STE 330",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631323035",
            "telephone_number": "314-877-8510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAYLOCK-SOLAR",
        "first_name": "DE-ANDREA",
        "name_prefix": "Mrs.",
        "credential": "MSW, LCSW, CST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-20",
        "last_updated": "2023-05-09",
        "certification_date": "2023-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2010006307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DE-ANDREA",
            "last_name": "BLAYLOCK-JOHNSON",
            "middle_name": "LESLIE",
            "prefix": "MRS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jeffrey Alan Blatnik, MD
• Terra Rupert Blatnik, MD
• Andrew N Blatt, MD
• Mary C Blatt, OD
• Joshua Andrew Blatter, MD
• Emily Thompson Blazevic
• James Blazier
• Carolyn Blechle, M.S.
• Jessica Blechle, PA-C
• Morganne Rae Blechle

• Clinical Social Worker in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Clinical Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.