Elizabeth Anne Blake, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

2982 Issued in NC

Practice address

2711 Pinedale Rd Ste a
Greensboro, NC 27408-4706

Phone

(336) 540-9400

Fax

(336) 540-9454

NPI assigned

Aug 28, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Cornerstone Psychological Services, PA

  • Mental Health Counselor
  • Greensboro, NC
  • NPI 1174578652
  NPD (past)

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

{
    "created_epoch": "1156723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053429290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2711 PINEDALE RD STE A",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274084706",
            "telephone_number": "336-540-9400",
            "fax_number": "336-540-9454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2711 PINEDALE RD STE A",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274084706",
            "telephone_number": "336-540-9400",
            "fax_number": "336-540-9454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "ELIZABETH",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "2982",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6102403",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tommy Alan Blackwell, D.D.S.
• Blair Kahzan Center
• Wendy Sanders Blair, PA-C
• Brittany Ann Blake, PHARMD
• Charletha Renee Blake
• Natalie L Blake, MD
• Sandra L Blake, FNP
• Susan D Blake, LPC
• Jeffrey Galen Blanchard, RPH
• Olivia Irene Blanchard, RN

• Mental Health Counselor in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.