Spencer Thomas Blake
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Ames, IA
NPI 1346909991 · NPPES record last updated Dec 10, 2021
Key facts
- NPI
- 1346909991
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- T20064 (IA)
- Practice address
- 804 Kellogg Ave
Ames, IA 50010-6234 - Phone
- (515) 233-4930
- NPI assigned
- Dec 10, 2021
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| T20064 | IA | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Youth and Shelter Services, Inc. | Addiction (Substance Use Disorder) | Past |
Accepting new patients |
Interoperability endpoints
- https://api.qualifacts.org/api/fhir/yss/r4/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | T20064 | IA | Yes |
Addresses
Primary practice location
804 Kellogg Ave
Ames, IA 50010-6234
Mailing address
420 Kellogg Ave
Ames, IA 50010-6226
Phone (515) 233-3141
Other providers in Ames, IA
- James Bice
- Gloria S Billings
- Michael Robert Bird
- Dylan Bishop
- Emily Black
- April Blong
- Laura Ann Bloomenrader
- Blooming Heart Counseling
- Rachel Boatman
- Kessa Lynn Bochek
All providers in Ames, IA · Addiction (Substance Use Disorder) Counselor in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 10, 2021. 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.