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)CodeLicenseStatePrimary
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

All providers in Stoneham, MA · Mental Health Counselor in Massachusetts

Sources for this page

Verify at the official NPI Registry.