Provider Demographics
NPI:1801817382
Name:BLAIR, BARBARA LYNN (MSW, LICSW)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:LYNN
Last Name:BLAIR
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:246 WOODS HOLE RD
Mailing Address - Street 2:
Mailing Address - City:FALMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02540-1673
Mailing Address - Country:US
Mailing Address - Phone:508-274-8220
Mailing Address - Fax:
Practice Address - Street 1:246 WOODS HOLE RD
Practice Address - Street 2:
Practice Address - City:FALMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02540-1673
Practice Address - Country:US
Practice Address - Phone:508-274-8220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2020-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10256811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA791434OtherTUFTS HEALTH PLAN
MAPO7112OtherBLUE CROSS BLUE SHIELD
MA197317000OtherMAGELLAN
MAP20106Medicare ID - Type Unspecified