NICOLE BLAKE (NPI# 1962022350) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962022350 |
| Entity Type | Individual |
| Full Name | NICOLE BLAKE |
| Other Name | NICOLE JEWELL |
| Credential | LMSW-CC, CADC |
| Practice Address |
400 Commercial St Portland ME 04101-4660 |
| Practice Telephone | 6038604900 |
| Mailing Telephone | 6038604900 |
| Enumeration Date | 2020-04-25 |
| Last Update Date | 2020-08-24 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | MC18881 | ME | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699384057 | Nicole Blake | Behavior Technician | 1724 Marshall St, Baltimore, MD 21230-4819 | 2020-07-30 |
| 1750676904 | Nicole Marie Blake | Physical Therapist | 4924 Campbell Blvd, Baltimore, MD 21236-5908 | 2011-06-16 |
| Street Address |
400 COMMERCIAL ST |
| City | PORTLAND |
| State | ME |
| Zip Code | 04101-4660 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306450655 | Jocylin Egan | Nurse Practitioner | 442 Congress Street, 2nd Floor, Portland, ME 04101 | 2020-09-03 |
| 1255963559 | Portcity Home Healthcare LLC | In Home Supportive Care | 525 Forest Avenue, Suite 8, Portland, ME 04101 | 2020-02-05 |
| 1578101929 | Mohamed Hassan Mohamed | Student in an Organized Health Care Education/Training Program | 75 Lancaster St Ste 218a, Portland, ME 04101 | 2019-12-17 |
| 1841855301 | Portland Opioid Health Home | Counselor | 48 Free St., Mezzanine Level, Portland, ME 04101 | 2019-05-09 |
| 1093379224 | Alexandra Strawbridge Maurer | Acupuncturist | 50 A Cove Street, Portland, ME 04101 | 2019-04-23 |
| 1245719541 | Scott J Whited | Nurse Practitioner | 216 Vaughan St., Mcgeachy Hall, Portland, ME 04101 | 2018-08-08 |
| 1144733064 | Alixandria Elaine Marie Winchell | Massage Therapist | One City Center, Portland, ME 04101 | 2017-11-14 |
| 1417473638 | Rachel S Schwaner | Occupational Therapist | 78 Danforth Street, Apartment 6, Portland, ME 04101 | 2017-08-18 |
| 1023538154 | Derina Boothroyd | Audiologist-Hearing Aid Fitter | 985 Forest Ave., Portland, ME 04101 | 2017-06-20 |
| 1881123297 | Mark Mccullough | Social Worker | 57 Exchange Street, Suite 403, Portland, ME 04101 | 2017-06-08 |
| Find all providers in zip 04101 | ||||
| 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 |
|---|---|---|---|---|
| 1104427160 | Kristine Lee Jones | Counselor | 2628 Se 87th Ave, Portland, OR 97266-1530 | 2020-11-05 |
| 1932711322 | Rachel Wilson | Counselor | 1020 Se 7th Ave # 14283, Portland, OR 97214-2387 | 2020-08-18 |
| 1851919906 | Anjana Rajan | Counselor | Lifeworks Northwest, 14600 Nw Cornell Rd, Portland, OR 97229 | 2020-07-06 |
| 1972124196 | Outside In | Counselor | 16144 E Burnside St, Portland, OR 97233-3520 | 2020-04-28 |
| 1912527201 | Alexa Jenkins | Counselor | 2700 Se Stark St Apt 3, Portland, OR 97214-3499 | 2020-04-16 |
| 1467086629 | Katelan Ruby Hostetler | Counselor | 13300 Ne San Rafael St, Portland, OR 97230-3123 | 2020-02-26 |
| 1356973770 | Laura Kille | Counselor | Wise Counsel and Comfort, 2045 Se Hawthorne Blvd., Portland, OR 97214 | 2020-02-05 |
| 1093346777 | Sprout Therapy Pdx LLC | Counselor | 7704 N Hereford Ave, Portland, OR 97203-3434 | 2020-01-30 |
| 1861030553 | Steve Bijoga | Counselor | 1350 Forest Ave Apt 16, Portland, ME 04103-1815 | 2019-12-13 |
| 1962043521 | Ladan Radafshar | Counselor | 1017 Sw Morrison St Ste 315, Portland, OR 97205-2628 | 2019-10-04 |
| Find all providers in PORTLAND | ||||
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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.