Shakeya Tyneice Blakes

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

00000000000 Issued in CT

Practice address

1 Enterprise Dr Ste 415
Shelton, CT 06484-4631

Phone

(203) 255-5078

Fax

(203) 295-7663

NPI assigned

Oct 23, 2024

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

Other names 1

• Ms. Shakeya Tyneice Blakes Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1729641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1114748951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 CRESCENT ST",
            "city": "ANSONIA",
            "state": "CT",
            "postal_code": "064012161",
            "telephone_number": "203-400-7304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ENTERPRISE DR STE 415",
            "city": "SHELTON",
            "state": "CT",
            "postal_code": "064844631",
            "telephone_number": "203-255-5078",
            "fax_number": "203-295-7663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKES",
        "first_name": "SHAKEYA",
        "middle_name": "TYNEICE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-23",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CT",
            "license": "00000000000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHAKEYA",
            "last_name": "BLAKES",
            "middle_name": "TYNEICE",
            "prefix": "MS.",
            "credential": "MASTERS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Mental Health Counselor in Shelton, CT
• Providers in Shelton, CT by specialty
• Mental Health Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2024; 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.