Provider Demographics
NPI:1699101279
Name:BLAU, ARIEL G (MSW, MFA)
Entity type:Individual
Prefix:
First Name:ARIEL
Middle Name:G
Last Name:BLAU
Suffix:
Gender:M
Credentials:MSW, MFA
Other - Prefix:
Other - First Name:EDGARDO
Other - Middle Name:A
Other - Last Name:GOLDBERGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3 CLINTON STREET
Mailing Address - Street 2:
Mailing Address - City:TORONTO
Mailing Address - State:ON
Mailing Address - Zip Code:M6J 2N7
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3 CLINTON STREET
Practice Address - Street 2:
Practice Address - City:TORONTO
Practice Address - State:ON
Practice Address - Zip Code:M6J 2N7
Practice Address - Country:CA
Practice Address - Phone:416-697-8103
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-16
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT58.0102111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical