JEFFREY BLAKE (NPI# 1639616295) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639616295 |
| Entity Type | Individual |
| Full Name | JEFFREY BLAKE |
| Practice Address |
474 W 200 N St George UT 84770-4505 |
| Practice Telephone | 4356345600 |
| Enumeration Date | 2017-01-20 |
| Last Update Date | 2017-06-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106S00000X | Behavior Technician | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003827239 | Jeffrey Blake | Social Worker | 22 Monument Square, #403, Portland, ME 04101-3914 | 2006-08-11 |
| 1407834781 | Jeffrey Lee Blake | Physical Therapist | 1714 17th St, Santa Monica, CA 90404-4410 | 2006-01-06 |
| 1477545127 | Jeffrey M Blake | Obstetrics & Gynecology | 141 W 22nd St Ste 309, Anderson, IN 46016-4389 | 2005-08-18 |
| 1164431185 | Jeffrey W Blake | Internal Medicine | 1620 Nectarine St, Fernandina Beach, FL 32034-4724 | 2006-08-07 |
| 1093734451 | Jeffrey Blake | Pediatrics | 317 Martin Luther King Jr Way, Tacoma, WA 98405-4234 | 2006-07-18 |
| 1992792980 | Jeffrey D. Blake | Obstetrics & Gynecology | 250 Green St, Gardner, MA 01440-1396 | 2005-10-04 |
| Street Address |
474 W 200 N |
| City | ST GEORGE |
| State | UT |
| Zip Code | 84770-4505 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548212640 | Southwest Center | Clinic/Center | 474 W 200 N, #300, St George, UT 84770-4505 | 2006-05-17 |
| 1538784160 | Mikenda Pearl Busic | Technician, Other | 474 W 200 N, St George, UT 84770-4505 | 2020-06-09 |
| 1912521022 | Dana Moody | Counselor | 474 W 200 N, St George, UT 84770-4505 | 2020-06-04 |
| 1285258533 | Lana Kathleen Wimmer | Counselor | 474 W 200 N, St George, UT 84770-4505 | 2020-06-02 |
| 1558985283 | Abel Ortiz | Social Worker | 474 W 200 N, St George, UT 84770-4505 | 2020-05-28 |
| 1104447960 | Holly Edwards | Registered Nurse | 474 W 200 N, St George, UT 84770-4505 | 2020-05-04 |
| 1275154486 | Kaitlan B Terry | Social Worker | 474 W 200 N, St George, UT 84770-4505 | 2020-04-28 |
| 1265069926 | Lupita Ann Holiday | Technician, Other | 474 W 200 N, St George, UT 84770-4505 | 2020-03-24 |
| 1942835046 | Elizabrth Hagen | Technician, Other | 474 W 200 N, St George, UT 84770-4505 | 2020-03-09 |
| 1215568530 | Willie C Townsend IIi | Case Manager/Care Coordinator | 474 W 200 N, St George, UT 84770-4505 | 2020-01-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740808500 | Redstone Reference Laboratories Inc | Clinical Medical Laboratory | 556 N Dixie Drive, Suite 2, St George, UT 84770 | 2020-07-08 |
| 1033776315 | Ecko Ashmore | Marriage & Family Therapist | 1173 S. 250 W. Bld 1 Ste 208, St. George, UT 84770 | 2019-05-22 |
| 1740844679 | Amy Darragh | Behavior Technician | 249 E Tabernacle St, Ste 100, St George, UT 84770 | 2019-04-25 |
| 1124598198 | Loren Kyle Gulbranson | Internal Medicine | Dixie Regional Medical Center, 515 South, 300 East, Saint George, UT 84770 | 2018-12-03 |
| 1487150728 | Sound Sleep Medical LLC | Durable Medical Equipment & Medical Supplies | 640 East 700 South Building 2, St. George, UT 84770 | 2018-04-04 |
| 1588162911 | Desert Edge Medical | Family Medicine | 1664 S Dixie Dr Ste D201, St George, UT 84770 | 2018-01-31 |
| 1568981314 | Jeffrey Joseph Peterson | Behavior Technician | 162 N 400 E Ste A-105, St. George, UT 84770 | 2017-09-13 |
| 1992242549 | Zachary Carey | Specialist/Technologist | 1115 W Diamond Valley Dr, Saint George, UT 84770 | 2017-01-20 |
| 1669920427 | Charles Taylor Church | Technician, Other | 474 West 200 East, St. George, UT 84770 | 2016-09-21 |
| 1952755480 | Hollystic Hideaway | Voluntary or Charitable | 1418 W Sunset Blvd. # 2, Saint George, UT 84770 | 2016-04-21 |
| Find all providers in zip 84770 | ||||
| Taxonomy Code | 106S00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Behavior Technician |
| The behavior technician is a paraprofessional who practices under the close, ongoing supervision of a behavior analyst or assistant behavior analyst certified by the Behavior Analyst Certification Board and/or credentialed by a state (such as through licensure). The behavior technician is primarily responsible for the implementation of components of behavior-analytic treatment plans developed by the supervisor. That may include collecting data on treatment targets and conducting certain types of behavioral assessments (e.g., stimulus preference assessments). The behavior technician does not design treatment or assessment plans or procedures but provides services as assigned by the supervisor responsible for his or her work. |
| Notes: Association of Professional Behavior Analysts, www.apbahome.net and Behavior Analyst Certification Board (http://www.bacb.com) [7/1/2016: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942825716 | Lauren Curry | Behavior Technician | 1722 E 280 N # O, St George, UT 84790-1631 | 2020-06-08 |
| 1740844679 | Amy Darragh | Behavior Technician | 249 E Tabernacle St, Ste 100, St George, UT 84770 | 2019-04-25 |
| 1225529779 | Elise Adams | Behavior Technician | 1240 E 100 S Ste 7, St George, UT 84790-3072 | 2018-05-21 |
| 1518489665 | Shelbi Lillian Holt | Behavior Technician | 230 N 1680 E Ste A, St George, UT 84790-2574 | 2017-07-11 |
| 1811425309 | Jenae Holt | Behavior Technician | 474 W 200 N # 300, St George, UT 84770-4505 | 2017-05-26 |
| 1578096970 | Kristilyn Gelder | Behavior Technician | 1680 E 230 N, Bldg A, St George, UT 84790 | 2017-04-04 |
| 1619414117 | Jazmine Torres | Behavior Technician | 2265 E 350 N, St George, UT 84790-2427 | 2017-01-23 |
| 1902355118 | Rachael Reid | Behavior Technician | 2985 E 1975 South Cir, St George, UT 84790-5112 | 2016-09-28 |
| 1417591595 | Braedon Watts | Behavior Technician | 249 E Tabernacle St Ste 100, St George, UT 84770-2951 | 2019-11-01 |
| 1932743317 | Bobbie Jo Forsyth | Behavior Technician | 249 E Tabernacle St Ste 100, St George, UT 84770-2951 | 2019-10-29 |
| Find all providers in ST GEORGE | ||||
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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.