Mary Elizabeth Blake

Individual provider Active NPI Mental Health Counselor · Columbus, MS

NPI 1225635451 · NPPES record last updated Oct 1, 2020

Key facts

NPI
1225635451
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
Practice address
1001 Main St
Columbus, MS 39701-4751
Phone
(662) 328-9225
NPI assigned
Oct 1, 2020
Sex
Female
Sole proprietor
No

Organizations & group practices 2

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Region Seven Mental Health Intellectual Disabilities Comm Past
since Oct 4, 2020
Accepting new patients
Region Seven Mental Health Idd Commission Mental Health Past
since Oct 4, 2020
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Yes

Addresses

Primary practice location

1001 Main St
Columbus, MS 39701-4751

Mailing address

302 N Jackson St
Starkville, MS 39759-2504
Phone (662) 323-9318

Other providers in Columbus, MS

All providers in Columbus, MS · Mental Health Counselor in Mississippi

Sources for this page

Verify at the official NPI Registry.