KECIA MARIE BLAKELY (NPI# 1750602355) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750602355 |
| Entity Type | Individual |
| Full Name | KECIA MARIE BLAKELY |
| Credential | MS |
| Practice Address |
308 E 21st Ave Gary IN 46407-2618 |
| Practice Telephone | 2198861320 |
| Practice Fax Number | 2198861319 |
| Mailing Telephone | 2198861320 |
| Mailing Fax Number | 2198861319 |
| Enumeration Date | 2010-06-17 |
| Last Update Date | 2010-06-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | Behavioral Health & Social Service Providers |
| Street Address |
308 E 21ST AVE |
| City | GARY |
| State | IN |
| Zip Code | 46407-2618 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144353715 | Willowglen Academy - Indiana | Residential Treatment Facility, Emotionally Disturbed Children | 308 E 21st Ave, Gary, IN 46407-2618 | 2007-03-13 |
| 1376974246 | Willowglen Academy-in, Inc. | Social Worker | 308 E 21st Ave, Gary, IN 46407-2618 | 2013-12-03 |
| 1023339587 | Tashena R Lollis | Social Worker | 308 E 21st Ave, Gary, IN 46407-2618 | 2010-06-18 |
| 1194046698 | Bunnie J Fleming | Licensed Practical Nurse | 308 E 21st Ave, Gary, IN 46407-2618 | 2010-06-18 |
| 1790006302 | Darlene Roseta Tolbert | Registered Nurse | 308 E 21st Ave, Gary, IN 46407-2618 | 2010-06-17 |
| 1073834875 | Marilyn M. Caruthers | Social Worker | 308 E 21st Ave, Gary, IN 46407-2618 | 2010-06-15 |
| 1073788113 | Willowglen Academy - Indiana | Residential Treatment Facility, Emotionally Disturbed Children | 308 E 21st Ave, Gary, IN 46407-2618 | 2008-04-29 |
| 1730384207 | Alexis Nelson | Social Worker | 308 E 21st Ave, Gary, IN 46407-2618 | 2007-06-15 |
| 1598960064 | Terald Blakey | Counselor | 308 E 21st Ave, Gary, IN 46407-2618 | 2007-06-15 |
| 1720283278 | Pamela Gabor | Social Worker | 308 E 21st Ave, Gary, IN 46407-2618 | 2007-06-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477802270 | Planned Parenthood of Indiana Gary | Clinic/Center | 1124 Broadway, Gary, IN 46407 | 2012-09-07 |
| 1891930913 | Angela Juanita Anderson | General Practice | 2353 Madison Street, Gary, IN 46407 | 2008-12-03 |
| 1548470537 | Rae Emerick | Speech-Language Pathologist | 2350 Taft Street, Gary, IN 46407 | 2007-05-22 |
| 1467577049 | Lavearn May | Registered Nurse | 308 E. 21st Avenue, Gary, IN 46407 | 2007-03-20 |
| 1881719532 | Kenneth Hicks | Social Worker | 308 East 21st Avenue, Gary, IN 46407 | 2007-03-20 |
| 1356476287 | Chube Medical Corporation | Family Medicine | 1701 Broadway, Gary, IN 46407 | 2007-02-22 |
| 1346263217 | Pulaski Memorial Hospital | Nursing Facility/Intermediate Care Facility | 700 E 21st Ave, Gary, IN 46407 | 2006-07-25 |
| 1477042505 | Ileana Green | Nurse Practitioner | 1400 Broadway, Gary, IN 46407 | 2018-05-03 |
| 1275734949 | Kenneth Edward Anderson | Speech-Language Pathologist | 2350 Taft St, Timberview Health Care Center, Gary, IN 46407 | 2007-05-30 |
| 1669555991 | David D Chube Sr. | Family Medicine | 1701 Broadway, Gary, IN 46407 | 2006-10-23 |
| Find all providers in zip 46407 | ||||
| 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 |
|---|---|---|---|---|
| 1679623235 | Corinthian Christian Center | Psychologist | 667 Van Buren St, Gary, IN 46402-2240 | 2007-01-12 |
| 1164588745 | Lawrence G. Ruffin | Psychologist | 1991 W 39th Ct Fl 2, Gary, IN 46408-2474 | 2006-12-28 |
| 1588759013 | Waltee Douglas | Psychologist | 667 Van Buren, Gary, IN 46402 | 2006-10-03 |
| 1699842377 | Anne M Wells | Psychologist | 4795 Broadway, Gary, IN 46409-2403 | 2006-11-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689273849 | Anahli Mayank Patel | Psychologist | 550 University Blvd Ste 1602, Indianapolis, IN 46202-5149 | 2020-10-20 |
| 1861006587 | Dr Michael Jones Psychological Associates, LLC | Psychologist | 8510 Evergreen Ave Ste 106, Indianapolis, IN 46240-2338 | 2020-09-01 |
| 1477171122 | Ellen Vaughan | Psychologist | 201 N Rose Ave Rm 4054, Bloomington, IN 47405-1005 | 2020-07-09 |
| 1881222016 | Ericka Swanson Psyd Inc. | Psychologist | 9305 Calumet Ave Ste A2, Munster, IN 46321-2888 | 2020-04-01 |
| 1184251316 | Pei-yi Lin | Psychologist | 9504 Rachel Dr, Yorktown, IN 47396-9826 | 2020-03-26 |
| 1679109383 | Christina Chico | Psychologist | 1 Park Row St, Michigan City, IN 46360-6597 | 2020-03-14 |
| 1457998007 | Ne Psychological LLC | Psychologist | 6343 Constitution Dr, Fort Wayne, IN 46804-1547 | 2019-12-03 |
| 1124674908 | Indianapolis Neurobehavioral Health Center LLC | Psychologist | 921 E. 86th St., Suite 210 C, Indianapolis, IN 46240 | 2019-08-16 |
| 1295205615 | Monumental Behavioral Health Inc | Psychologist | 1201 N Post Rd Ste C, Indianapolis, IN 46219-4246 | 2018-11-28 |
| 1528536083 | Rebecca Martinez Reid | Psychologist | 2201 E Woodstock Pl, Bloomington, IN 47401-6180 | 2018-11-02 |
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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.