TIMOTHY CARL BLAKE (NPI# 1003044066) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003044066 |
| Entity Type | Individual |
| Full Name | TIMOTHY CARL BLAKE |
| Practice Address |
725 Highland Ave Winston Salem NC 27101-4206 |
| Mailing Address |
284 Executive Park Dr Suite 100 Concord NC 28025-1831 |
| Practice Telephone | 3366078523 |
| Enumeration Date | 2009-06-29 |
| Last Update Date | 2009-06-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508288135 | Timothy Blake | Hearing Instrument Specialist | 343 Elm St, Suite 204, Reno, NV 89503-4522 | 2014-01-16 |
| 1649602723 | Timothy E. Blake | Physical Therapist | 5899 Bremo Rd, Suite 100, Richmond, VA 23226-1935 | 2013-07-31 |
| 1568796613 | Timothy G Blake | Psychologist | 2649 Park Ave, Minneapolis, MN 55407-1006 | 2009-09-22 |
| 1891790986 | Timothy Daniel Blake | Ophthalmology | 5 Coliseum Ave, Nashua, NH 03063-3292 | 2005-06-16 |
| Street Address |
725 HIGHLAND AVE |
| City | WINSTON SALEM |
| State | NC |
| Zip Code | 27101-4206 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477544377 | Theresa Catherine Burgess | Psychiatry & Neurology | 725 Highland Ave, Suite 100, Winston Salem, NC 27101-4180 | 2005-10-31 |
| 1952873663 | Deshanna Johnson | Counselor | 725 Highland Ave, Winston Salem, NC 27101-4180 | 2018-12-19 |
| 1275021479 | Teresa Jo Harris | Licensed Practical Nurse | 725 Highland Ave, Winston Salem, NC 27101-4180 | 2018-04-24 |
| 1073001392 | Shavonna Ann Robinson | Licensed Practical Nurse | 725 Highland Ave, Winston Salem, NC 27101-4180 | 2018-04-23 |
| 1053863829 | Brianne Hawkins | Counselor | 725 Highland Ave, Suite 100, Winston Salem, NC 27101-4180 | 2016-10-27 |
| 1881052595 | Anna Harris | Counselor | 725 Highland Ave, Winston Salem, NC 27101-4180 | 2016-02-09 |
| 1174908545 | Nichole M Brown | Registered Nurse | 725 Highland Ave, Winston Salem, NC 27101-4180 | 2015-07-27 |
| 1528451721 | Jerry Myers | Counselor | 725 Highland Ave, Suite 100, Winston Salem, NC 27101-4180 | 2015-03-12 |
| 1326446089 | Meghan Rachel Stout | Counselor | 725 Highland Ave, Winston Salem, NC 27101-4180 | 2014-12-11 |
| 1326450024 | Daymark Recovery | Counselor | 725 Highland Ave, Winston Salem, NC 27101-4180 | 2014-05-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003421876 | Annie Carolina Mccollum | Occupational Therapist | 3 S Martin Luther King Jr Dr, Winston-salem, NC 27101 | 2020-09-09 |
| 1891321337 | Philippe Ayres | Personal Emergency Response Attendant | 475 Vine St., Bowman Gray Center for Medical Education, Winston-salem, NC 27101 | 2020-03-17 |
| 1497385595 | Aereil Moore | Counselor | 655 West 4th St, Winston Salem, NC 27101 | 2020-01-17 |
| 1619519428 | Brandi Melissa Decriscio | Nurse Practitioner | 1200 N Martin Luther King Jr Drive, Winston-salem, NC 27101 | 2019-10-14 |
| 1316502909 | Burke Street Chiropractic, Pllc | Chiropractor | 1016 Burke St., Winston-salem, NC 27101 | 2019-05-08 |
| 1790349728 | Nakia Carter | Counselor | 1o1o W. Northwest Boulevard, Winston-salem, NC 27101 | 2019-04-25 |
| 1003391251 | Hannah Fortwengler Rainey | Nurse Anesthetist, Certified Registered | Medical Center Blvrd, Winston-salem, NC 27101 | 2018-10-03 |
| 1750875928 | Susan Wilhelm Patterson | Nurse Practitioner | 1200 Martin Luther King Jr Dr, Winston-salem, NC 27101 | 2018-06-20 |
| 1194228049 | Anjanette Gilley Benjamin | Counselor | 650 Highland Ave Ste 1000, Winston Salem, NC 27101 | 2018-03-16 |
| 1376054627 | Paulisha Da-shawna Mcintyre | Social Worker | 650 Highland Ave Ste 101, Winston Salem, NC 27101 | 2017-10-13 |
| Find all providers in zip 27101 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669021994 | Martha B Metzler | Counselor | 121 Reynolda Vlg Ste A, Winston Salem, NC 27106-5126 | 2019-09-09 |
| 1407335953 | Valera Counseling Services, Pllc | Counselor | 4680 Brownsboro Rd Rm A2, Winston Salem, NC 27106-3428 | 2018-08-07 |
| 1477039675 | Fengdi Pei | Counselor | 2325 Hilltop Dr, Winston Salem, NC 27106-4220 | 2018-07-11 |
| 1376059840 | Danielle Clark Moore | Counselor | 500 W 4th St Ste 203, Winston Salem, NC 27101-2782 | 2017-12-20 |
| 1679921597 | Nicholas Chase Salmons | Counselor | 203 S Stratford Rd Ste A, Winston Salem, NC 27103-1872 | 2016-06-01 |
| 1295102002 | Sarah Vavreck | Counselor | 1025 W End Blvd, 1, Winston Salem, NC 27101-2657 | 2015-08-27 |
| 1063893865 | Guruji Products Inc | Counselor | 1801 Olivers Crossing Cir, Winston Salem, NC 27127-7133 | 2015-06-17 |
| 1407253776 | Amy Bond Craver | Counselor | 620 Holly Ave, Winston Salem, NC 27101 | 2014-12-02 |
| 1093136525 | Chantal D Hayes | Counselor | 1348 Westgate Center Dr Ste 202, Winston Salem, NC 27103-2984 | 2013-12-31 |
| 1396095907 | Anita Ellen Fadden | Counselor | 665 W. 4th Street, Winston Salem, NC 27101 | 2012-09-12 |
| Find all providers in WINSTON SALEM | ||||
| City | WINSTON SALEM |
| Zip Code | 27101 |
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| 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.