Kandace Blake, MA, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SP-9750-SL Issued in MA

Practice address

863 Hathaway Rd
New Bedford, MA 02740-1916

Phone

(803) 261-9039

NPI assigned

Dec 17, 2015

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1450310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450310400000",
    "number": "1013372127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1755 WITTINGTON PL",
            "address_2": "STE. #175",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752341927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "863 HATHAWAY RD",
            "city": "NEW BEDFORD",
            "state": "MA",
            "postal_code": "027401916",
            "telephone_number": "803-261-9039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "KANDACE",
        "credential": "MA, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-12-17",
        "last_updated": "2015-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MA",
            "license": "SP-9750-SL",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Azzam Bittar, MD
• Sarah Bjornson
• Ann Rae Black, RN
• Sara E Black, MSW
• Alex Donald Blackburn
• Jessica Blakeley, OTR/L
• Conor Bliss
• Sherry Bloomfield, D.D.S.
• Blue World Counseling
• Wendy Bluis, CAC

• Speech-Language Pathologist in New Bedford, MA
• Providers in New Bedford, MA by specialty
• Speech-Language Pathologist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.