Julie Blaske, MA LADC LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

3106 Issued in MN

Practice address

1310 Hwy 96 E
Suite 200
White Bear Lake, MN 55110

Phone

(612) 241-6004

NPI assigned

Feb 3, 2016

Last updated

Jul 21, 2022By 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 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1454457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1124486246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3515 TIFFANY LANE",
            "city": "SHOREVIEW",
            "state": "MN",
            "postal_code": "55126",
            "telephone_number": "651-238-2840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 HWY 96 E",
            "address_2": "SUITE 200",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "55110",
            "telephone_number": "612-241-6004"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "620 Civic Heights Dr",
            "address_2": "Suite 103",
            "address_purpose": "LOCATION",
            "city": "Circle Pines",
            "state": "MN",
            "postal_code": "550144711",
            "country_code": "US",
            "telephone_number": "651-238-2840",
            "fax_number": "763-657-0819",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLASKE",
        "first_name": "JULIE",
        "credential": "MA LADC LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-03",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "303395",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "3106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Marriage & Family Therapist in White Bear Lake, MN
• Providers in White Bear Lake, MN by specialty
• Marriage & Family Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.