TIMOTHY G BLAKE (NPI# 1568796613) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568796613 |
| Entity Type | Individual |
| Full Name | TIMOTHY G BLAKE |
| Credential | LP |
| Practice Address |
2649 Park Ave Minneapolis MN 55407-1006 |
| Practice Telephone | 6126761604 |
| Practice Fax Number | 6123798235 |
| Mailing Telephone | 6126761604 |
| Mailing Fax Number | 6123798235 |
| Enumeration Date | 2009-09-22 |
| Last Update Date | 2009-09-22 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | 5115 | MN | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508288135 | Timothy Blake | Hearing Instrument Specialist | 343 Elm St, Suite 204, Reno, NV 89503-4522 | 2014-01-16 |
| 1649602723 | Timothy E. Blake | Physical Therapist | 5899 Bremo Rd, Suite 100, Richmond, VA 23226-1935 | 2013-07-31 |
| 1003044066 | Timothy Carl Blake | Counselor | 725 Highland Ave, Winston Salem, NC 27101-4206 | 2009-06-29 |
| 1891790986 | Timothy Daniel Blake | Ophthalmology | 5 Coliseum Ave, Nashua, NH 03063-3292 | 2005-06-16 |
| Street Address |
2649 PARK AVE |
| City | MINNEAPOLIS |
| State | MN |
| Zip Code | 55407-1006 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124080742 | Vessela M Kouneva | Marriage & Family Therapist | 2649 Park Ave, Minneapolis, MN 55407 | 2006-04-06 |
| 1174940076 | Park Avenue Center Mental Health Services | Substance Abuse Rehabilitation Facility | 2649 Park Ave, Minneapolis, MN 55407-1006 | 2014-03-28 |
| 1275880809 | Kelley Ann Sehman | Counselor | 2649 Park Ave, Minneapolis, MN 55407-1006 | 2012-08-14 |
| 1821386988 | Joan Whiton | Social Worker | 2649 Park Ave, Minneapolis, MN 55407-1006 | 2011-07-11 |
| 1588959134 | Wendy L Mathiason | Social Worker | 2649 Park Ave, Minneapolis, MN 55407-1006 | 2011-06-11 |
| 1396045225 | Karin M Nystrom | Social Worker | 2649 Park Ave, Minneapolis, MN 55407-1006 | 2010-10-26 |
| 1912226820 | Christin L Seirup | Social Worker | 2649 Park Ave, Minneapolis, MN 55407-1006 | 2010-05-18 |
| 1891027454 | Jillian Marie Ellingson | Counselor | 2649 Park Ave, Minneapolis, MN 55407-1006 | 2010-02-08 |
| 1871722371 | Stephen Eugene Calvit | Social Worker | 2649 Park Ave, Minneapolis, MN 55407-1006 | 2009-07-07 |
| 1801038989 | John Marshall Lampert | Marriage & Family Therapist | 2649 Park Ave, Minneapolis, MN 55407-1006 | 2009-04-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720644057 | Amana Home Care | Home Health | 2833 13th Ave S Suite 118, Minneapolis, MN 55407 | 2019-05-13 |
| 1356802979 | Aaron Randy Pickrel | Student in an Organized Health Care Education/Training Program | 2800 Chicago Avenue, #250, Minneapolis, MN 55407 | 2019-03-27 |
| 1053881631 | Naimo Abdisalam | Registered Nurse | 1229 East Lake Street, Minneapolis, MN 55407 | 2018-11-27 |
| 1437639614 | Kelly Usitalo | Nurse Practitioner | 913 E 26th Street, Piper Building Suite 401, Minneapolis, MN 55407 | 2018-08-17 |
| 1952880346 | Allison Hall | Internal Medicine | Minneapolis Heart Institute, 920 E 28 St. #300, Minneapolis, MN 55407 | 2018-08-07 |
| 1780176370 | Rebekah Sand | Physical Therapist | 2800 Chicage Avenue S, Suite 102, Minneapolis, MN 55407 | 2018-05-31 |
| 1417448663 | Vivian T.c. Liu | Student in an Organized Health Care Education/Training Program | 2020 E 28th Street, Suite 104, Minneapolis, MN 55407 | 2018-05-23 |
| 1053802397 | Isuroon | Counselor | 1600 East Lake Street Suite 1, Minneapolis, Mpls, MN 55407 | 2018-05-22 |
| 1154811404 | Mohamed Mukhtar Ali | Dentist | 4700 Cedar Ave S, Minneapolis, MN 55407 | 2018-05-12 |
| 1396254280 | Erin Elizabeth Casper | Registered Nurse | 3621 Oakland Ave, Minneapolis, MN 55407 | 2017-09-25 |
| Find all providers in zip 55407 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407496516 | Liza N Meredith | Psychologist | Acacia Counseling and Wellness, 2724 University Ave Se Unit B, Minneapolis, MN 55414 | 2020-01-07 |
| 1194368191 | Luz Angelica Fehn Salinas | Psychologist | 1315 E24th St, Minneapolis, MN 55404 | 2019-10-22 |
| 1164071148 | Amy C Moran | Psychologist | Acacia Counseling & Wellness, 2724 University Ave., Unit B, Minneapolis, MN 55414 | 2019-09-11 |
| 1104482074 | Sanvello Behavioral Health Services, P.a. | Psychologist | 150 S 5th St Ste 825, Minneapolis, MN 55402-4200 | 2019-05-15 |
| 1033674726 | Kristina Marie Duncombe Lowe | Psychologist | 910 E 26th St Ste 410, Minneapolis, MN 55404-4512 | 2019-02-06 |
| 1083192223 | Krista Yucuis | Psychologist | 725 8th Ave Se, Minneapolis, MN 55414-1364 | 2018-07-31 |
| 1720564941 | Shani Ofrat | Psychologist | 1 Veterans Dr # 2g-128, Minneapolis, MN 55417-2309 | 2018-07-11 |
| 1962998997 | Steven Wolinski | Psychologist | 3830 Washburn Ave N, Minneapolis, MN 55412 | 2018-07-02 |
| 1497268122 | Andrea Lynn Potthoff | Psychologist | 7300 Metro Blvd Ste 640, Minneapolis, MN 55439-2313 | 2017-11-16 |
| 1871046912 | Christine E Bray | Psychologist | 1100 Washington Ave S, Suite 102, Minneapolis, MN 55415-1273 | 2016-07-25 |
| Find all providers in MINNEAPOLIS | ||||
| City | MINNEAPOLIS |
| Zip Code | 55407 |
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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.