Banaly Blaise, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Orlando, Florida. Her current practice location is
8430 Rose Groves Rd, Orlando, Florida. You can reach out to her office (for appointments etc.) via phone at
(407) 859-2882.
Banaly Blaise is licensed to practice in * (Not Available) (license number ) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1225578495.
Healthcare Provider's Profile
| Full Name | Banaly Blaise |
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| Gender | Female |
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| Speciality | Social Worker - Clinical |
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| Location | 8430 Rose Groves Rd, Orlando, Florida |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1225578495
- Provider Enumeration Date: 03/07/2017
- Last Update Date: 04/06/2021
Medicare PECOS Information:
- PECOS PAC ID: 7012320849
- Enrollment ID: I20210115000298
Medical Identifiers
Medical identifiers for Banaly Blaise such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1225578495 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Banaly Blaise allows following entities to bill medicare on her behalf.
| Entity Name | Mtca Psychological Services P.a. |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1740552322
PECOS PAC ID: 6406010834
Enrollment ID: O20120614000204 |
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| Entity Name | Families First Of Florida Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1881746543
PECOS PAC ID: 6800325457
Enrollment ID: O20250127000796 |
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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. Banaly Blaise is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Banaly Blaise, LCSW
8430 Rose Groves Rd,
Orlando, FL 32818-5689
Ph: () - | Banaly Blaise, LCSW
8430 Rose Groves Rd,
Orlando, FL 32818-5689
Ph: (407) 859-2882 |
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