Johannah Blake, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

229492 Issued in AZ

Practice address

2919 E Broadway Blvd # 205
Tucson, AZ 85716-5301

Phone

(520) 654-5502

Fax

(520) 842-8765

NPI assigned

Sep 16, 2019

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 AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Leaf and Stone PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Tucson, AZ
  • NPI 1356030951
  Medicare reassignment NPD Authorized official
• Samantha Frembgen, D.O. PLLC

  • Psychiatry Physician
  • Tucson, AZ
  • NPI 1225667561

  Psychiatric/Mental Health

  NPD

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

{
    "created_epoch": "1568592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745712000000",
    "number": "1609426261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "975 N SILVERBELL RD UNIT 85194",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857544009",
            "telephone_number": "520-861-4414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2919 E BROADWAY BLVD # 205",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857165301",
            "telephone_number": "520-654-5502",
            "fax_number": "520-842-8765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "JOHANNAH",
        "name_prefix": "Ms.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-16",
        "last_updated": "2025-04-27",
        "certification_date": "2025-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "229492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Blair, LCSW, LISAC
• Rosalee Valdivia Blair, PHARMD
• Charles Blake, M.D.
• Christina Blake, FNP, IBCLC
• Donna H Blake, PSYCHOTHERAPIST
• Jonathan Blake, DPT
• Olivia Rachel Blake
• Miranda Blakeslee, MA, MT-BC
• Carlos H Blancarte Sr., LPN
• Shirley Blancas, M.D.

• Psychiatric/Mental Health Nurse Practitioner in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Psychiatric/Mental Health Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2025; 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.