Jamilia Blake, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

36053 Issued in TX

Practice address

207 Rock Prairie Rd Ste B
Capstone
College Station, TX 77845-8777

Phone

(404) 725-2592

Fax

(979) 694-7337

NPI assigned

May 23, 2012

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)

Enrolled

Credentials

Doctor of Philosophy

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.

• Jamilia Blake

  • Psychologist
  • College Station, TX
  • NPI 1225390594
  NPD (past) Authorized official
• Grow Forward Counseling PLLC

  • Marriage & Family Therapist
  • College Station, TX
  • NPI 1548031305
  NPD (past)

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

{
    "created_epoch": "1337731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339459200000",
    "number": "1114287133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12173",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778422173",
            "telephone_number": "404-725-2592",
            "fax_number": "979-694-7337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 ROCK PRAIRIE RD STE B",
            "address_2": "CAPSTONE",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778458777",
            "telephone_number": "404-725-2592",
            "fax_number": "979-694-7337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "JAMILIA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-23",
        "last_updated": "2012-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TX",
            "license": "36053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul David Rocky Bilhartz, M.D., M.B.A.
• Rebecca Bischoff
• Valerie Lee Bivona, CRNA
• Brent T. Black, DDS
• Brian Scott Black, D.D.S.
• Aniki Blanchard, LCDC
• Jennifer J Blasingame, M.D.
• Alexandra Blazek
• Britney Bledsoe, LMSW
• Dean Blevins, MD

• Psychologist in College Station, TX
• Providers in College Station, TX by specialty
• Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2012; 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.