Syreeta L Blake

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

P016937 Issued in NC

Practice address

100 Loop St
Clinton, NC 28328-4062

Phone

(919) 596-2221

Fax

(919) 587-0007

NPI assigned

Oct 28, 2021

Sex

Female

Sole proprietor

No

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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Specialty

Clinical Social Worker

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Elysium Counseling, PLLC

  • Mental Health Counselor
  • Goldsboro, NC
  • NPI 1669222402
  NPD (past)

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

{
    "created_epoch": "1635379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635379200000",
    "number": "1033873609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 JACOBS RIDGE DR",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275347395",
            "telephone_number": "850-621-0051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 LOOP ST",
            "city": "CLINTON",
            "state": "NC",
            "postal_code": "283284062",
            "telephone_number": "919-596-2221",
            "fax_number": "919-587-0007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "SYREETA",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-28",
        "last_updated": "2021-10-28",
        "certification_date": "2021-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P016937",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gurvinder Singh Bhatti, DDS
• Angela Lynne Binkowski, DO
• Bio-Medical Applications of Clinton, Inc.
• Susan Cartrette Birtch, RPH
• Robert Talmadge Blackwood Jr., PA-C
• Bme Home Care Agency
• Bme Home Care Agency, Inc
• Linda Rita Boggs, PA-C
• Shelby Monroe Boock, DO
• Marshall Johnson Bowen, CRNA

• Clinical Social Worker in Clinton, NC
• Providers in Clinton, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.