Virginia L. Blake, LADC, CCS, LSW

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

LC3675 Issued in ME

Practice address

127 Palmer St
Calais, ME 04619-1300

Phone

(207) 454-0270

Fax

(207) 454-0232

NPI assigned

Apr 12, 2012

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Aroostook Mental Health Services, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Presque Isle, ME
  • NPI 1487601399
  NPD (past)

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

{
    "created_epoch": "1334188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334188800000",
    "number": "1659638955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 PALMER ST",
            "city": "CALAIS",
            "state": "ME",
            "postal_code": "046191300",
            "telephone_number": "207-454-0270",
            "fax_number": "207-454-0232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 PALMER ST",
            "city": "CALAIS",
            "state": "ME",
            "postal_code": "046191300",
            "telephone_number": "207-454-0270",
            "fax_number": "207-454-0232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "VIRGINIA",
        "middle_name": "L.",
        "credential": "LADC, CCS, LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-12",
        "last_updated": "2012-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "ME",
            "license": "LC3675",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103850000",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda D Barrows, LCSW
• Dawn Marie Barry, REGISTERED NURSE
• Timothy G Baxter, MS, LPC, LCPC
• Ann L Beckham, LCSW
• Samuel Dalogdog Benigno, PHYSICAL THERAPIST
• Michael Steven Bodkin, RNFA
• Bold Coast Rehabilitation Services LLC
• Tamara Suzanne Boots, D.O.
• Debra Anne Marie Boucaud, NP
• Ann Boudreaux, PA

• Addiction (Substance Use Disorder) Counselor in Calais, ME
• Providers in Calais, ME by specialty
• Addiction (Substance Use Disorder) Counselor in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2012; 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.