Kyla Machell Blalock, PHD

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

5393 Issued in NC

Practice address

3500 Westgate Dr Ste 900
Durham, NC 27707-2534

Phone

(919) 891-3096

NPI assigned

Aug 21, 2018

Last updated

Dec 6, 2023By 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 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• Anna Elizabeth Craig PHD Clinical Psychologist

  dba Bull City Behavioral Health

  • Adolescent and Children Mental Health Clinic/Center
  • Durham, NC
  • NPI 1316643950
  NPD Authorized official

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

{
    "created_epoch": "1534809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701820800000",
    "number": "1598245292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 WESTGATE DR STE 900",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277072534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 WESTGATE DR STE 900",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277072534",
            "telephone_number": "919-891-3096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLALOCK",
        "first_name": "KYLA",
        "middle_name": "MACHELL",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-21",
        "last_updated": "2023-12-06",
        "certification_date": "2023-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "5393",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NC",
            "license": "5393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pashyon N Blake, MSW, LCSWA
• Stephanie McCallum Blake, MSN, NNP-BC
• Thomas Matthew Blakemore, PA-C
• Shannon Blakey, PHD
• Daniel Vanhoy Blalock, PHD
• Sarah Blanchard, MD
• Tyra Blanchard
• Paula Blanco Canet, MS, RD
• Claudia Adriana Blanco
• Meredith Elise Bland, DPT, ATC

• Clinical Child & Adolescent Psychologist in Durham, NC
• Providers in Durham, NC by specialty
• Clinical Child & Adolescent Psychologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.