Kecia Blakely, MSP, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

KECIA BLAKELY, MSP, LMHC

Practice address

52189 Scott St
South Bend, IN 46637

Phone

(574) 208-3359

NPI assigned

Jul 26, 2023

Organization subpart

No

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

Authorized official

Name

Kecia Marie Blakely, LMHCNPI 1750602355

Title

Owner

Phone

(574) 800-9681

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kecia Marie Blakely, MSPSY, LMHC

  • Mental Health Counselor
  • South Bend, IN
  • NPI 1750602355
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1690329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725321600000",
    "number": "1598446395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52189 SCOTT ST",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466372952",
            "telephone_number": "574-800-9681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52189 SCOTT ST",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "46637",
            "telephone_number": "574-208-3359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KECIA BLAKELY, MSP, LMHC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-26",
        "last_updated": "2024-09-03",
        "certification_date": "2024-09-03",
        "status": "A",
        "authorized_official_last_name": "BLAKELY",
        "authorized_official_first_name": "KECIA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "574-800-9681",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Philip Richard Kavanagh, DO
• Courtney R Kavanaugh, OTR
• Angela Christine Kay, PA
• Layla Ann Kayser
• Kearn D Hinchman D O Inc
• Craig Keefe
• Danica Vera Hernandez Keefe, M.ED. BCBA
• Sarah Elizabeth Keel, LCSW, LMSW
• Brooke Keen, PHARMD
• David James Keenan, H.I.S.

• Mental Health Counselor in South Bend, IN
• Providers in South Bend, IN by specialty
• Mental Health Counselor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.