Mackenzie Blomstrom

Primary specialty

Social WorkerTaxonomy code 104100000X

License

116902 Issued in NY

Practice address

222 W 21St St Apt 3F
New York, NY 10011-3485

Phone

(571) 659-1549

NPI assigned

Jul 2, 2020

Reactivated

Sep 29, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Abacs, LLC

  • Behavior Technician
  • Woburn, MA
  • NPI 1720515711
  NPD (past)
• Behavioral Concepts

  • Behavior Technician
  • Woburn, MA
  • NPI 1063008530
  NPD (past)

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

{
    "created_epoch": "1593648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664409600000",
    "number": "1992322218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 W 21ST ST APT 3F",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100113485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 W 21ST ST APT 3F",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100113485",
            "telephone_number": "571-659-1549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOMSTROM",
        "first_name": "MACKENZIE",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-02",
        "last_updated": "2022-09-29",
        "certification_date": "2022-09-29",
        "deactivation_date": "2022-07-25",
        "reactivation_date": "2022-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "116902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marianna Blokh, DPM
• Sue Erikson Bloland, LCSW
• Inga Blom, PHD
• Margaret Lee Blom
• Sandrine Blomstedt
• Courtney Blonder, CF-SLP TSSLD
• Ofra Blonder, MD
• Alan Peter Blondman, D.D.S.
• Max Blondman, D.D.S.
• Emmeline Ryan Blong, LMSW

• Social Worker in New York, NY
• Providers in New York, NY by specialty
• Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2022; 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.