Active NPI
Nathaniel Allen Blake, CFBPPC, LCAS
- Pastoral Counselor
- Burlington, NC
National Provider Identifier
1659889640
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pastoral Counselor
- License
- 116
- Practice address
- 1230 Saint Marks Church Rd
Burlington, NC 27215-9797 - Phone
- (336) 227-5476
- Fax
- (336) 437-1898
- NPI assigned
- Jan 12, 2018
- Last updated
- Feb 5, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 22716 | NC | |
| Pastoral Counselor | 101YP1600X | 116 | NC | Primary |
Addresses
Primary practice location
1230 Saint Marks Church Rd
Burlington, NC 27215-9797
Mailing address
1230 Saint Marks Church Rd
Burlington, NC 27215-9797
Phone (336) 227-5476
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carenet, Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1515715200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1580860800000",
"number": "1659889640",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1230 SAINT MARKS CHURCH RD",
"city": "BURLINGTON",
"state": "NC",
"postal_code": "272159797",
"telephone_number": "336-227-5476",
"fax_number": "336-437-1898"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1230 SAINT MARKS CHURCH RD",
"city": "BURLINGTON",
"state": "NC",
"postal_code": "272159797",
"telephone_number": "336-227-5476",
"fax_number": "336-437-1898"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLAKE",
"first_name": "NATHANIEL",
"middle_name": "ALLEN",
"name_prefix": "Mr.",
"credential": "CFBPPC, LCAS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-01-12",
"last_updated": "2020-02-05",
"certification_date": "2020-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NC",
"license": "22716",
"primary": false
},
{
"code": "101YP1600X",
"taxonomy_group": "",
"desc": "Counselor, Pastoral",
"state": "NC",
"license": "116",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Burlington, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.