Jonathan Blake
Individual provider Active NPI Mental Health Counselor · Stoneham, MA
NPI 1235624313 · NPPES record last updated Jun 27, 2022
Key facts
- NPI
- 1235624313
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- Practice address
- 219 Green St
Stoneham, MA 02180-1372 - Phone
- (781) 424-8238
- NPI assigned
- Jun 29, 2018
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Yes |
Addresses
Primary practice location
219 Green St
Stoneham, MA 02180-1372
Mailing address
219 Green St
Stoneham, MA 02180-1372
Phone (781) 424-8238
Other providers in Stoneham, MA
- Karen Binder
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- BJS Wholesale Club Inc
- Blake Medical LLC
- Wanda P Blanton
- Adam Blau
- Bloom Therapy LLC
- Timothy Bodzioch
- Stefanie F Boisvert
All providers in Stoneham, MA · Mental Health Counselor in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 27, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.