DR. BLAKE F WHITE JR. (NPI# 1255465886) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255465886 |
| Entity Type | Individual |
| Full Name | DR. BLAKE F WHITE JR. |
| Credential | PH.D. |
| Practice Address |
5623 Bosque Vista Dr Ne Albuquerque NM 87111-8067 |
| Practice Telephone | 5059173862 |
| Mailing Telephone | 5059173862 |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2014-03-31 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103TC0700X |
Psychologist Specialization: Clinical |
213 | NM | Behavioral Health & Social Service Providers |
| Y | 103TP0016X |
Psychologist Specialization: Prescribing (Medical) |
0033 | NM | Behavioral Health & Social Service Providers |
| Street Address |
5623 BOSQUE VISTA DR NE |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87111-8067 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417438110 | Dehlen LLC | Counselor | 11000 Spain Rd Ne, Building E, Albuquerque, NM 87111 | 2018-08-22 |
| 1003313008 | Jessika Junick | Nurse Practitioner | 3825 Eubank Blvd Ne Ste A, Albuquerque, NM 87111 | 2018-04-07 |
| 1881113454 | Hayley Aragon-bell | Day Training/Habilitation Specialist | 3732 Mount Rainier Dr. Ne, Albuquerque, NM 87111 | 2017-09-14 |
| 1750803326 | Sarah Mckenzie Ochoa | Day Training/Habilitation Specialist | 3916 Garcia St Ne, Albuquerque, NM 87111 | 2017-07-14 |
| 1285179549 | Family Dental Health Care | Dentist | 4550 Eubank Blvd, Suite 203, Albuquerque, NM 87111 | 2016-12-22 |
| 1871036202 | Shobha Jagannath | Nurse Practitioner | 10700 Academy Rd Ne Apt 216, Albuquerque, NM 87111 | 2016-12-03 |
| 1508319310 | Mariana Boitano | Licensed Practical Nurse | 5400 Gibson Blvd., Albuquerque, NM 87111 | 2016-07-28 |
| 1184011082 | Adam Halpern | Specialist/Technologist | 4204 Parsifal St, Albuquerque, NM 87111 | 2015-04-20 |
| 1083015770 | Cvs Pharmacy | Public Health or Welfare | 5516 Camino Arbustos Ne, Albuquerque, NM 87111 | 2014-09-12 |
| 1508276973 | Stephanie Gonzales | Physician Assistant | 12241 Academy Rd Ne Ste 204, Albuquerque, NM 87111 | 2014-05-06 |
| Find all providers in zip 87111 | ||||
| Taxonomy Code | 103TP0016X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Prescribing (Medical) |
| Those licensed psychologists who have completed specialized, post-doctoral training in psychopharmacology, passed a national proficiency examination in psychopharmacology, and who are authorized by state statute to prescribe medications, in accordance with their state law and state licensing authority, for the evaluation, diagnosis, management and treatment of mental, nervous, emotional, behavioral, and related disorders. |
| Notes: Source: Louisiana Academy of Medical Psychologists Note: Some states issue licenses under Medical Psychologist. [1/1/2007: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003218553 | Integrated Healthcare of New Mexico | Psychologist | 7632 William Moyers Ave Ne, Albuquerque, NM 87122-2765 | 2014-09-16 |
| 1245856913 | Paul King-miller Psyd Lpcc LLC | Psychologist | 11216 Brentwood Hills Blvd Ne, Albuquerque, NM 87112-3219 | 2020-06-18 |
| 1477585990 | Deborah Leslie Kos | Psychologist | 4810 Hardware Dr Ne, Albuquerque, NM 87109-2013 | 2006-07-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417489378 | Primary Wellness Team Corporation | Psychologist | 5805 Mcnutt Rd, Ste D, Santa Teresa, NM 88008-8001 | 2017-03-30 |
| 1154877371 | J. Michael Mash Prescribing Psychologist LLC | Psychologist | 4155 State Road 68, Unit 6, Rancho De Taos, NM 87557 | 2016-08-28 |
| 1124466446 | Shekinah Foundation | Psychologist | 3001 S Wyoming Ave, Roswell, NM 88203-2326 | 2013-06-08 |
| 1902197098 | S M Cobb | Psychologist | 400 N Pennsylvania Ave Ste 990, Roswell, NM 88201-4754 | 2011-04-25 |
| 1730203860 | Pattijo N Velasquez | Psychologist | 1505 S Don Roser Dr, Ste. A, Las Cruces, NM 88011-4596 | 2007-03-16 |
| 1285232397 | Dr Tony J Kreuch LLC | Psychologist | 2204 Brothers Rd Ste B, Santa Fe, NM 87505-6975 | 2020-10-12 |
| 1548677669 | Winds of Change Mental Health Services, LLC | Psychologist | 108 E High St, Grants, NM 87020-2453 | 2014-07-21 |
| 1982024105 | Drw Behavioral Health Services, LLC | Psychologist | 1395 Missouri Ave, Las Cruces, NM 88001-5327 | 2014-04-27 |
| City | ALBUQUERQUE |
| Zip Code | 87111 |
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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.