Nichelle Catherine Blakesley

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

111242 Issued in IA

Practice address

3301 Cedar Heights Dr
Cedar Falls, IA 50613-6041

Phone

(319) 493-7613

Fax

(319) 249-0508

NPI assigned

Dec 28, 2021

Last updated

Sep 4, 2024By 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 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Safe Space Therapy

  • Clinical Social Worker
  • Cedar Falls, IA
  • NPI 1205707577
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1640649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725408000000",
    "number": "1184384455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 CEDAR HEIGHTS DR",
            "city": "CEDAR FALLS",
            "state": "IA",
            "postal_code": "506136041",
            "telephone_number": "319-493-7613",
            "fax_number": "319-249-0508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 CEDAR HEIGHTS DR",
            "city": "CEDAR FALLS",
            "state": "IA",
            "postal_code": "506136041",
            "telephone_number": "319-493-7613",
            "fax_number": "319-249-0508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKESLEY",
        "first_name": "NICHELLE",
        "middle_name": "CATHERINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-28",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "111242",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "324505128",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jenna Zalk Berendzen, DNP, PMHNP-BC, FNP-C
• Bethesda Group Home and Staffing Agency LLC
• Bijelic Counseling and Consulting Services LLC
• Ljubomirka Bijelic-Appenzeller, TLMHC
• Donald Lee Bishop, MA, ATC, LAT
• Lauren Paige Block, DC
• Tristan Boaldin, DPT
• Lucas S Boe, DMD
• Robert W Boezinger, LCSW
• Michael Boller

• Clinical Social Worker in Cedar Falls, IA
• Providers in Cedar Falls, IA by specialty
• Clinical Social Worker in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.