Blake Perez, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

77299 Issued in TX

Practice address

2141 Office Park Dr Ste 3
San Angelo, TX 76904-6836

Phone

(325) 223-2347

NPI assigned

Jun 20, 2021

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Mental Health Counselor

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Concho Valley Center for Human AdvancementGroup PAC ID 7719936533, 7 clinicians

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 and National Provider Directory roles.

• Concho Valley Center for Human Advancement

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • San Angelo, TX
  • NPI 1164479192

  Professional

  Medicare reassignment Care Compare group NPD
• Concho Valley Center for Human Advancement

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • San Angelo, TX
  • NPI 1801937495

  Professional

  NPD

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

{
    "created_epoch": "1624147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624147200000",
    "number": "1396314852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2141 OFFICE PARK DR STE 3",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769046836",
            "telephone_number": "325-223-2347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2141 OFFICE PARK DR STE 3",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769046836",
            "telephone_number": "325-223-2347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "BLAKE",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-20",
        "last_updated": "2021-06-20",
        "certification_date": "2021-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "77299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erika Diane Peiser, PTA
• Jasmine Jae Pena
• Elizabeth Ann Penkert, EIS-FQP
• Lorena Del Milagro Perez Povis, MD
• Ana Isabel Perez, EIS-FQP
• Michael Perez, DO
• Elizabeth Ann Perkins, RBT
• Judith D. Perkins, BS PT
• Kenneth Adrian Perret II, M.D.
• Nyssah Dawn Perrine, RN, FPMHNP-BC

• Professional Counselor in San Angelo, TX
• Providers in San Angelo, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2021; 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.