Carol Blair, LCSWR

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

R040861-1 Issued in NY

Practice address

92 East Lake Ave
Massapequa Park, NY 11762-2502

Phone

(516) 799-5031

Fax

(516) 799-8303

NPI assigned

Dec 11, 2006

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

Medicare fee-for-service enrollment

Enrolled in NY

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, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972663920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92 EAST LAKE AVE",
            "city": "MASSAPEQUA PARK",
            "state": "NY",
            "postal_code": "117622502",
            "telephone_number": "516-799-5031",
            "fax_number": "516-799-8303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 EAST LAKE AVE",
            "city": "MASSAPEQUA PARK",
            "state": "NY",
            "postal_code": "117622502",
            "telephone_number": "516-799-5031",
            "fax_number": "516-799-8303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAIR",
        "first_name": "CAROL",
        "credential": "LCSWR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R040861-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Ellen Baumann, CCC-LSP
• Behavior Change Success Corp
• Gina Marie Belfiore
• Corinne Beyer, PHYSICIAN ASSISTANT
• Vladislav Beylik, OTR/L
• Robert Blair, PMHNP, RN
• Victoria Bligh
• Amy Bonanno, OTR/L
• Lauren Borgersen
• Michele Marie Borget-de Vos, LCSW-R

• Clinical Social Worker in Massapequa Park, NY
• Providers in Massapequa Park, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.