Active NPI
Donna H Blake, PSYCHOTHERAPIST
- Professional Counselor
- Tucson, AZ
National Provider Identifier
1124160106
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC2202
- Practice address
- 5210 E Pima St
Suite 200
Tucson, AZ 85712-3664 - Phone
- (520) 795-9313
- Fax
- (520) 777-5768
- NPI assigned
- Feb 13, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC2202 | AZ | Primary |
Addresses
Primary practice location
5210 E Pima St
Suite 200
Tucson, AZ 85712-3664
Mailing address
5210 E Pima St
Suite 200
Tucson, AZ 85712-3664
Phone (520) 795-9313
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124160106 | Other | AZ | NATIONAL PROVIDER IDENTIFIER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC2202 | AZ | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171324800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1365206400000",
"number": "1124160106",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5210 E PIMA ST",
"address_2": "SUITE 200",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857123664",
"telephone_number": "520-795-9313",
"fax_number": "520-777-5768"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5210 E PIMA ST",
"address_2": "SUITE 200",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857123664",
"telephone_number": "520-795-9313",
"fax_number": "520-777-5768"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLAKE",
"first_name": "DONNA",
"middle_name": "H",
"name_prefix": "Ms.",
"credential": "PSYCHOTHERAPIST",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-13",
"last_updated": "2013-04-06",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "AZ",
"license": "LPC2202",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NATIONAL PROVIDER IDENTIFIER",
"identifier": "1124160106",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tucson, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.