Veronica Blakely

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

005630 Issued in GA

Practice address

3855 Presidential Pkwy
Atlanta, GA 30340-3705

Phone

(770) 451-6838

Fax

(770) 451-7804

NPI assigned

Apr 14, 2010

Last updated

Apr 14, 2010By the provider in NPPES

Sex

Female

Sole proprietor

No

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 GA

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sondermind Provider Network LLC

  • Clinical Social Worker
  • Denver, CO
  • NPI 1760854442

  GA

  Medicare reassignment NPD

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

{
    "created_epoch": "1271203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271203200000",
    "number": "1578889754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3855 PRESIDENTIAL PKWY",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303403705",
            "telephone_number": "770-451-6838",
            "fax_number": "770-451-7804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3855 PRESIDENTIAL PKWY",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303403705",
            "telephone_number": "770-451-6838",
            "fax_number": "770-451-7804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKELY",
        "first_name": "VERONICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-14",
        "last_updated": "2010-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "005630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victor Blake, MD
• William T Blake, MD
• Rayne Jahliah Blakely-Lopez, BA, MN, RN
• Chandra Blakely, LPC
• Lisa Dove Blakely, RN
• Nakayla Blakemore
• Gerald Blakey
• Lydia Blakey, DC
• Kayla Blalock-Brazile
• Andrew Clark Blalock, PH.D.

• Mental Health Counselor in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Mental Health Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2010; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.