MRS. LYNDA SHANE BLASKO PH.D.
NPI 1083937874
Psychologist in Atlanta, GA

Active since March 08, 2010Opted out of Medicare · through Jan 23, 2027
1409 NORTH HIGHLAND AVENUE, SUITE J, ATLANTA, GA 30306(404) 908-1773 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jul 21, 2022, Aug 24, 2017 (2 updates tracked since 2017).

About Mrs. Lynda Shane Blasko Ph.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. LYNDA SHANE BLASKO PH.D. (NPI 1083937874) is an individual psychologist in Atlanta, Georgia, licensed in Georgia (004067) and active in the NPI registry since March 2010. She has opted out of Medicare through January 23, 2027.

NPPES Registry Identity

NPI1083937874
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameMRS. LYNDA SHANE BLASKOCredential: PH.D.
Location Address1409 NORTH HIGHLAND AVENUE, SUITE JAtlanta, GA 30306
Mailing Address1290 Oaklawn Avenue NeBrookhaven, GA 30319 · (404) 908-1773
Sole ProprietorYes
Enumeration DateMarch 8, 2010
Last NPPES UpdateJuly 21, 20222 updates tracked since enumeration
NPI 1083937874 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License Licensed in GA · 004067
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.

Also ListedCounselorTaxonomy 101Y00000X
Also ListedPsychologist · CounselingTaxonomy 103TC1900X · License 004067 (GA)
1409 NORTH HIGHLAND AVENUE, Atlanta, GA 30306

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Opted out of Medicare

Mrs. Lynda Shane Blasko Ph.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 23, 2023 through January 23, 2027.

Opt-Out Effective DateJanuary 23, 2023
Opt-Out In Effect ThroughJanuary 23, 2027Opt-out affidavits renew automatically every two years unless cancelled

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lynda Blasko's NPI number?

The NPI number for Lynda Blasko is 1083937874. It was assigned to this individual provider in the NPPES registry on March 8, 2010.

Where is Lynda Blasko located?

Lynda Blasko practices at 1409 North Highland Avenue Suite J, Atlanta, GA 30306. The listed phone number is (404) 908-1773.

What is Lynda Blasko's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Lynda Blasko enrolled in Medicare?

No. Lynda Blasko has opted out of Medicare through January 23, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Lynda Blasko was last updated on July 21, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.