MRS. LYNDA SHANE BLASKO


Address: 1409 North Highland Avenue, Suite J, Atlanta, GA 30306
Phone: 4049081773

MRS. LYNDA SHANE BLASKO (NPI# 1083937874) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1083937874
Entity Type Individual
Full Name MRS. LYNDA SHANE BLASKO
Credential PH.D.
Practice Address 1409 North Highland Avenue
Suite J
Atlanta
GA 30306
Mailing Address 1290 Oaklawn Avenue Ne
Brookhaven
GA 30319
Practice Telephone 4049081773
Mailing Telephone (404) 908-1773
Enumeration Date 2010-03-08
Last Update Date 2017-08-24
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 101Y00000X Counselor Behavioral Health & Social Service Providers
Y 103T00000X Psychologist 004067 GA Behavioral Health & Social Service Providers
N 103TC1900X Psychologist
Specialization: Counseling
004067 GA Behavioral Health & Social Service Providers

Office Location

Street Address 1409 NORTH HIGHLAND AVENUE
SUITE J
City ATLANTA
State GA
Zip Code 30306

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Taxonomy Information

Taxonomy Code 103T00000X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist

Taxonomy Definition

A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
Notes: Source: American Psychological Association [1/1/2007: modified definition]

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City ATLANTA
Zip Code 30306

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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