Active NPI
Kai Bergondi Blake, M.ED
- School Psychologist
- Washington, DC
National Provider Identifier
1639626294
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- 10993888
- Practice address
- 1919 15TH St SE
Washington, DC 20020 - Phone
- (240) 412-8260
- NPI assigned
- Sep 1, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 10993888 | DC | Primary |
Addresses
Primary practice location
1919 15TH St SE
Washington, DC 20020
Mailing address
7800 Pomfret Rd
Pomfret, MD 20675-3218
Phone (240) 412-8260
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10993888 | DC | MD | School Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1472688000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1472688000000",
"number": "1639626294",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7800 POMFRET RD",
"city": "POMFRET",
"state": "MD",
"postal_code": "206753218",
"telephone_number": "240-412-8260"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1919 15TH ST SE",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "20020",
"telephone_number": "240-412-8260"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLAKE",
"first_name": "KAI",
"middle_name": "BERGONDI",
"credential": "M.ED",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-09-01",
"last_updated": "2016-09-01",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "DC",
"license": "10993888",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Washington, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.