Blake Ann Kish

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

CTB-2024-0290 Issued in NM

Practice address

2504 Camino Entrada
Santa Fe, NM 87507-4851

Phone

(505) 216-2727

NPI assigned

Oct 24, 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1571875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734566400000",
    "number": "1770126468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2504 CAMINO ENTRADA BLDG B",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875074851",
            "telephone_number": "505-216-2727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2504 CAMINO ENTRADA",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875074851",
            "telephone_number": "505-216-2727"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2504 Camino Entrada",
            "address_purpose": "LOCATION",
            "city": "Santa Fe",
            "state": "NM",
            "postal_code": "875074851",
            "country_code": "US",
            "telephone_number": "505-471-9453 x115",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KISH",
        "first_name": "BLAKE",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-24",
        "last_updated": "2024-12-19",
        "certification_date": "2024-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "CTB-2024-0290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cindy L Kirby, PT
• George Russell Kirkland Jr., D.D.S.
• Ruth Kirkpatrick, RN
• Kirsten Nelson LLC
• Jeffrey Kiser, APRN
• Christina Emily Kithil, N.D.
• Vanessa Kitzis, MD
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• Andrea Irene Klann, LCSW
• John A Klauck Jr., DO

• Mental Health Counselor in Santa Fe, NM
• Providers in Santa Fe, NM by specialty
• Mental Health Counselor in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2024; 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.