BRENDA REBECCA BLAKE (NPI# 1285243436) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285243436 |
| Entity Type | Individual |
| Full Name | BRENDA REBECCA BLAKE |
| Practice Address |
3876 Beverly Ave Ne Bldg G Salem OR 97305-1319 |
| Mailing Address |
20356 Ferry Rd Se Stayton OR 97383-9658 |
| Practice Telephone | 5037635734 |
| Mailing Telephone | 5033835206 |
| Enumeration Date | 2020-07-23 |
| Last Update Date | 2020-07-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487073938 | Brenda Blake | Counselor | 697 Pro-med Ln, Carmel, IN 46032-5323 | 2014-04-14 |
| 1932274750 | Brenda G Blake | Counselor | 975 Bethesda Dr, Zanesville, OH 43701-7500 | 2006-11-21 |
| Street Address |
3876 BEVERLY AVE NE BLDG G |
| City | SALEM |
| State | OR |
| Zip Code | 97305-1319 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396926895 | Nicholas James Stroud | Social Worker | 3876 Beverly Ave Ne Bldg G, Salem, OR 97305-1319 | 2007-11-26 |
| 1396360863 | Rachel Rose Mccall | Peer Specialist | 3876 Beverly Ave Ne Bldg G, Salem, OR 97305-1319 | 2020-06-10 |
| 1841814746 | Madison Anne Dulany | Peer Specialist | 3876 Beverly Ave Ne Bldg G, Salem, OR 97305-1319 | 2020-06-05 |
| 1215596093 | Shayla Michele Richardson | Case Manager/Care Coordinator | 3876 Beverly Ave Ne Bldg G, Salem, OR 97305-1319 | 2019-06-06 |
| 1528626330 | Michael Kelly Martin | Case Manager/Care Coordinator | 3876 Beverly Ave Ne Bldg G, Salem, OR 97305-1319 | 2019-06-05 |
| 1750872446 | Fernando Rincon Mata | Case Manager/Care Coordinator | 3876 Beverly Ave Ne Bldg G, Salem, OR 97305-1319 | 2018-05-29 |
| 1336630730 | Jennifer Lomeli | Case Manager/Care Coordinator | 3876 Beverly Ave Ne Bldg G, Salem, OR 97305-1319 | 2018-05-22 |
| 1346757911 | Rosa M Noriega | Peer Specialist | 3876 Beverly Ave Ne Bldg G, Salem, OR 97305-1319 | 2018-01-04 |
| 1407368285 | Torey Jarrett | Case Manager/Care Coordinator | 3876 Beverly Ave Ne Bldg G, Salem, OR 97305-1319 | 2017-11-01 |
| 1396254215 | Dana Morris | Social Worker | 3876 Beverly Ave Ne Bldg G, Salem, OR 97305-1319 | 2017-09-22 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821639147 | Christine Ann Featherstone | Social Worker | Chemawa Indian Health Center, 3750 Chemawa Road, Salem, OR 97305 | 2019-10-08 |
| 1962996553 | Erin Ann Wakefield | Non-emergency Medical Transport (VAN) | 2425 Fisher Rd Ne, Salem, OR 97305 | 2018-06-18 |
| 1770002271 | Traci L Lee | Case Manager/Care Coordinator | 3876 Beverly Ave Bldg G, Salem, OR 97305 | 2017-09-15 |
| 1952825762 | Matthew Paul Martin | Dentist | 2737 Lancaster Dr Ne Ste 150, Salem, OR 97305 | 2017-08-02 |
| 1043750367 | Sherri King | Physical Therapy Assistant | 4696 Reimann St Ne, Salem, OR 97305 | 2017-03-06 |
| 1760861314 | Amara Lenore Peterson | Counselor | 4347 Sunnyview Rd Ne, Salem, OR 97305 | 2015-05-28 |
| 1720467954 | Heather Rose | Community Health Worker | 4347 Sunnyview Road Ne, Salem, OR 97305 | 2015-05-20 |
| 1588057004 | Carmen Heidecke | Counselor | 4347 Sunnyview Rd. Ne, Salem, OR 97305 | 2015-03-08 |
| 1629476825 | Bryan James Greenaway | Audiologist | 3857 Wolverine St Ne Ste C-16, Salem, OR 97305 | 2014-12-21 |
| 1710300322 | Christopher Ryan | Counselor | 4385 Sunnyview Road Ne, Salem, OR 97305 | 2014-02-03 |
| Find all providers in zip 97305 | ||||
| Taxonomy Code | 171M00000X |
| Grouping | Other Service Providers |
| Classification | Case Manager/Care Coordinator |
| A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336755586 | Emma Theresa Cox | Case Manager/Care Coordinator | 33 Upham St Apt 3, Salem, MA 01970-2460 | 2020-09-22 |
| 1407475064 | Yolanda Loyer | Case Manager/Care Coordinator | 2789 E State St Ste 7, Salem, OH 44460-9327 | 2020-04-14 |
| 1770121501 | Stacy Bush Phillips | Case Manager/Care Coordinator | 1501 Mill Race Dr, Salem, VA 24153-3137 | 2019-12-11 |
| 1528618659 | Linda Diane Pierce | Case Manager/Care Coordinator | 1724 Broadway St Ne, Salem, OR 97301-0509 | 2019-09-20 |
| 1770002271 | Traci L Lee | Case Manager/Care Coordinator | 3876 Beverly Ave Bldg G, Salem, OR 97305 | 2017-09-15 |
| 1427576065 | Katherine Lingmai | Case Manager/Care Coordinator | 1790 23rd St. Ne, Salem, OR 97301 | 2017-09-04 |
| 1225577240 | Anjalique Benham | Case Manager/Care Coordinator | 5 Lancelot Ct, Apt#1, Salem, NH 03079-3555 | 2017-02-23 |
| 1518409762 | Melissa Ward | Case Manager/Care Coordinator | 1380 Southside Dr, Suite 100, Salem, VA 24153 | 2016-11-04 |
| 1467810945 | Carl Walton Kapocias | Case Manager/Care Coordinator | 750 Front St Ne, Salem, OR 97301-1089 | 2016-01-29 |
| 1215339361 | Kaylor Ficklin | Case Manager/Care Coordinator | 188 E 300 S, Salem, UT 84653-9453 | 2014-09-19 |
| Find all providers in SALEM | ||||
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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.