Mrs Lynda Shane Blasko, PHD is a
Psychologist based in Atlanta, Georgia. Mrs Lynda Shane Blasko is licensed to practice in Georgia (license number 004067) and her current practice location is
1409 North Highland Avenue, Suite J, Atlanta, Georgia. She can be reached at her office (for appointments etc.) via phone at
(404) 908-1773.
NPI number for Mrs Lynda Shane Blasko is 1083937874 and her current mailing address is 1290 Oaklawn Avenue Ne, Brookhaven, Georgia. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1083937874.
Healthcare Provider's Profile
| Full Name | Mrs Lynda Shane Blasko |
|---|
| Gender | Female |
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| Speciality | Psychologist |
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| Location | 1409 North Highland Avenue, Atlanta, Georgia |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1083937874
- Provider Enumeration Date: 03/08/2010
- Last Update Date: 07/21/2022
Medical Identifiers
Medical identifiers for Mrs Lynda Shane Blasko such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1083937874 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101Y00000X | Counselor | (* (Not Available)) | Secondary |
| 103TC1900X | Psychologist - Counseling | 004067 (Georgia) | Secondary |
| 103T00000X | Psychologist | 004067 (Georgia) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Lynda Shane Blasko is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mrs Lynda Shane Blasko, PHD
1290 Oaklawn Avenue Ne,
Brookhaven, GA 30319
Ph: (404) 908-1773 | Mrs Lynda Shane Blasko, PHD
1409 North Highland Avenue, Suite J,
Atlanta, GA 30306
Ph: (404) 908-1773 |
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