Jessica Louise Blodgett, LLPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

6401017014 Issued in MI

Practice address

4576 W Walton Blvd
Waterford, MI 48329-4905

Phone

(248) 742-1963

NPI assigned

Jan 18, 2019

Sex

Female

Sole proprietor

Yes

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": "1547769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547769600000",
    "number": "1780158170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13730 S 28TH ST",
            "city": "VICKSBURG",
            "state": "MI",
            "postal_code": "490979304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4576 W WALTON BLVD",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483294905",
            "telephone_number": "248-742-1963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLODGETT",
        "first_name": "JESSICA",
        "middle_name": "LOUISE",
        "name_prefix": "Ms.",
        "credential": "LLPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-18",
        "last_updated": "2019-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6401017014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly James Blake, OTR
• Melissa A Blake, OTR
• Stephen Joseph Blake Sr., DDS
• Joshua Andrew Blanden, CPSS
• Jacqueline Bleisch
• Bloom Wellness Direct Primary Care, PLLC
• Neil L Bluestone, R.PH
• Board of Education Oakland County
• Alyssa Lynn Boinais, LLMSW
• Richard Carl Bolten, DDS

• Mental Health Counselor in Waterford, MI
• Providers in Waterford, MI by specialty
• Mental Health Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2019; 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.