Blake Gagliardi

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

58.013172 Issued in CT

Practice address

50 Gaylord Farm Rd
Wallingford, CT 06492-2899

Phone

(203) 284-2800

NPI assigned

Aug 27, 2017

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1503792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698624000000",
    "number": "1962929323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 WHIFFLE TREE RD",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064922861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 GAYLORD FARM RD",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064922899",
            "telephone_number": "203-284-2800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "597 Randolph Ave",
            "address_purpose": "LOCATION",
            "city": "Milton",
            "state": "MA",
            "postal_code": "02186",
            "country_code": "US",
            "telephone_number": "617-433-3124",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 Longwood Ave",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021155724",
            "country_code": "US",
            "telephone_number": "908-370-8191",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAGLIARDI",
        "first_name": "BLAKE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-27",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "58.013172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Friar, M.D.
• Daria M Friel, D.M.D.
• Beth A Friess, LCSW
• Chad Fuggi
• Rachel Funaro, OTR/L
• Christine Gagliardi, COTA
• Jessica Gallagher, RBT
• Christina Koch Gamble, LMFT
• Chelsea Ann Gardner, FNP
• Stephanie Gawel, MS CCC- SLP

• Clinical Social Worker in Wallingford, CT
• Providers in Wallingford, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 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.