Kayla Blakey, MA, CRC, LPC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

178.016155 Issued in IL

Practice address

2020 Dempster St
Evanston, IL 60202-1017

Phone

(847) 905-0702

NPI assigned

Oct 29, 2020

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

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

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.

• Have Dreams

  • Community/Behavioral Health Agency
  • Park Ridge, IL
  • NPI 1568743482
  NPD

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

{
    "created_epoch": "1603929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603929600000",
    "number": "1083214993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 BUSSE HWY STE 150",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600683155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 DEMPSTER ST",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602021017",
            "telephone_number": "847-905-0702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKEY",
        "first_name": "KAYLA",
        "name_prefix": "Miss",
        "credential": "MA, CRC, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-29",
        "last_updated": "2020-10-29",
        "certification_date": "2020-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IL",
            "license": "178.016155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Lynn Black, LCPC, CCMHC, LBS1
• Jonella Renee Black, PT
• Miranda Brooke Blackburn
• Noel L. Blackburn, LCSW, PH.D.
• Brittney Johanna Blackwell, APN-CNP
• Stamata Blanas, D.D.S.
• Marino Blasini
• Judy M Blau, OTR/L, CHT
• Mari Bliss, M.S. CCC-SLP
• Richard Blitstein, L.AC.

• Counselor in Evanston, IL
• Providers in Evanston, IL by specialty
• Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2020; 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.