JENNIFER L BLAKE (NPI# 1457649204) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457649204 |
| Entity Type | Individual |
| Full Name | JENNIFER L BLAKE |
| Credential | MA |
| Practice Address |
11630 Se 40th Ave Suite A Milwaukie OR 97222-6195 |
| Practice Telephone | 5037945968 |
| Mailing Telephone | 5037945968 |
| Enumeration Date | 2011-07-14 |
| Last Update Date | 2011-07-14 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101Y00000X | Counselor | R1530 | OR | Behavioral Health & Social Service Providers |
| Y | 106H00000X | Marriage & Family Therapist | R1576 | OR | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629623574 | Jennifer Ann Blake | Social Worker | 5000 S 5th Ave Bldg 200, Hines, IL 60141-3030 | 2019-08-07 |
| 1508198078 | Jennifer Lynn Blake | Speech-Language Pathologist | 3161 Sw 50th St, Ft. Lauderdale, FL 33312 | 2010-02-08 |
| 1972620110 | Jennifer Kay Blake | Counselor | 150 Shelton Mcmurphey Blvd Ste 101, Eugene, OR 97401-5015 | 2007-03-23 |
| 1114552585 | Jennifer E Blake | Social Worker | 2900 W Prospect Rd, Fort Lauderdale, FL 33309-2519 | 2020-03-06 |
| 1497245708 | Jennifer Christina Blake | Student in an Organized Health Care Education/Training Program | 6410 Fannin St Ste 1400, Houston, TX 77030-5389 | 2018-05-11 |
| 1023535739 | Jennifer K Blake | Physical Therapist | 594 Broadway, New York, NY 10012-3233 | 2017-08-23 |
| 1942641550 | Jennifer Blake | Occupational Therapist | 2501 Downing St Sw, Wilson, NC 27893-4517 | 2013-07-11 |
| 1982998282 | Jennifer Lynn Blake | Physical Therapist | 506 Plain St, Suite 101, Marshfield, MA 02050-2744 | 2011-06-03 |
| 1598073835 | Jennifer Marie Blake | Registered Nurse | 601 E 15th St, Austin, TX 78701-1930 | 2010-09-21 |
| 1891952370 | Jennifer Marie Blake | Pediatrics | 3901 Beaubien St, Childrens Hospital of Mi 4th Fl, Detroit, MI 48201-2119 | 2008-05-21 |
| Street Address |
11630 SE 40TH AVE SUITE A |
| City | MILWAUKIE |
| State | OR |
| Zip Code | 97222-6195 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700865490 | Jacqueline Lee Geddes | Psychologist | 11630 Se 40th Ave, Suite A, Milwaukie, OR 97222-6195 | 2006-01-11 |
| 1700497377 | Jeffrey Rolland Meuser | Counselor | 11630 Se 40th Ave, Milwaukie, OR 97222-6195 | 2020-08-16 |
| 1538784269 | Ethan G Morrow | Counselor | 11630 Se 40th Ave, Milwaukie, OR 97222-6195 | 2020-06-09 |
| 1396383220 | Kimberly Ann Dudley | Counselor | 11630 Se 40th Ave, Milwaukie, OR 97222-6195 | 2019-12-10 |
| 1285081133 | Patrick Merle Sellin | Counselor | 11630 Se 40th Ave, Milwaukie, OR 97222-6195 | 2016-05-20 |
| 1043683105 | Wister Park Counseling, LLC | Public Health or Welfare | 11630 Se 40th Ave, Ste. A, Milwaukie, OR 97222-6195 | 2015-11-10 |
| 1558782748 | Dara Cantor | Acupuncturist | 11630 Se 40th Ave, Suite C, Milwaukie, OR 97222-6195 | 2013-12-15 |
| 1447693684 | Sheryl Lynn Ivey | Nurse Practitioner | 11630 Se 40th Ave, Suite A #7, Milwaukie, OR 97222-6195 | 2013-04-08 |
| 1013289529 | Flow Natural Health Care | Clinic/Center | 11630 Se 40th Ave, Suite C, Milwaukie, OR 97222-6195 | 2012-01-30 |
| 1629372537 | Richard K Lok | Naturopath | 11630 Se 40th Ave, Suite C, Milwaukie, OR 97222-6195 | 2011-01-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831731397 | Madalyn Kelly Yowell | Technician | 7809 Southeast Southgate Street, Milwaukee, OR 97222 | 2019-10-16 |
| 1336617448 | Nadia Yang | Social Worker | 2115 Se Adams St, Milwaukie, OR 97222 | 2018-11-06 |
| 1851892368 | Arrow Dental LLC | Dentist | 10505 Se 17th Avenue, Milwaukie, OR 97222 | 2018-02-21 |
| 1851814016 | Cathy Maria Andrew | Acupuncturist | 11022 Se Stanley Ave, Milwaukie, OR 97222 | 2017-07-19 |
| 1972025369 | Sarah Elizabeth Giles | Peer Specialist | 11097 Se 21st Ave., Milwaukie, OR 97222 | 2017-07-07 |
| 1366976292 | Brittany Reubendale | Physical Therapist | 12705 See River Rd, Portland, OR 97222 | 2017-04-18 |
| 1669916383 | Margie Hertz | Registered Nurse | 6406 Se Cedarcrest Drive, Milwaukie, OR 97222 | 2016-12-14 |
| 1952858094 | Alexis Escobar | Speech-Language Pathologist | 4560 Se International Way, Ste 100, Milwaukie, OR 97222 | 2016-09-07 |
| 1205295466 | Beth Ann Mills | Acupuncturist | 2025 Se Jefferson St Ste 106, Milwaukie, OR 97222 | 2016-02-16 |
| 1558744086 | Kyle Eugene Coan | Specialist | 3306 Se Wister St, Milwaukie, OR 97222 | 2015-07-01 |
| Find all providers in zip 97222 | ||||
| Taxonomy Code | 106H00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Marriage & Family Therapist |
| A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346440070 | Eric F. Nielson | Marriage & Family Therapist | 2100 Se Lake Rd, Suite 4, Milwaukie, OR 97222-7759 | 2007-07-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699382168 | Aja Meadows | Marriage & Family Therapist | 3783 Westleigh St, Eugene, OR 97405-1137 | 2020-09-28 |
| 1902410012 | High Vibe Society | Marriage & Family Therapist | 1582 Santiam Ave, Eugene, OR 97408-6004 | 2020-09-04 |
| 1669082061 | Kelsey Miller | Marriage & Family Therapist | 5515 N Williams Ave, Portland, OR 97217-2452 | 2020-07-31 |
| 1376152967 | Mahvash Azadegan | Marriage & Family Therapist | 16940 Sw Kattegat Dr, Beaverton, OR 97006-8953 | 2020-07-29 |
| 1558979559 | Took Smoot | Marriage & Family Therapist | 7427 Sw Coho Ct Ste 200no5, Tualatin, OR 97062-8618 | 2020-07-16 |
| 1255959631 | Veronica Terese Valdez | Marriage & Family Therapist | 4445 S Barbur Blvd Ste 205, Portland, OR 97239-4047 | 2020-07-11 |
| 1649896630 | Moving Forward Staying Present LLC | Marriage & Family Therapist | 8083 Se 13th Ave Ste 3, Portland, OR 97202-6668 | 2020-06-25 |
| 1700402070 | Devan Larsen | Marriage & Family Therapist | 20526 Mutt Ct, Bend, OR 97701-7935 | 2020-06-22 |
| 1346863677 | Dan Thomas Schmitt | Marriage & Family Therapist | 541 Willamette St Ste 301, Eugene, OR 97401-2692 | 2020-05-21 |
| 1992324909 | E. Kirsten Hughes, Lmft, LLC | Marriage & Family Therapist | 1991 Garden Ave, Eugene, OR 97403-1934 | 2020-04-09 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on JENNIFER L BLAKE.
| 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.