Stephanie Michelle Blakemore

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6851118066 Issued in MI

Practice address

1115 Ball Ave NE
Grand Rapids, MI 49505-5904

Phone

(616) 456-6571

NPI assigned

Sep 25, 2024

Sex

Unspecified or another gender identity

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Skye Blakemore Professional name

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": "1727222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727222400000",
    "number": "1801613328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2065 CAMBRIDGE DR SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495065235",
            "telephone_number": "616-916-0251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 BALL AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495055904",
            "telephone_number": "616-456-6571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKEMORE",
        "first_name": "STEPHANIE",
        "middle_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2024-09-25",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6851118066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SKYE",
            "last_name": "BLAKEMORE",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Jamie Blake
• Jodie Megan Blake, PT
• Shaunna Dior Blake
• Tai Blake, RN
• Barbara B Blakely, PA-C
• Danielle J Blanchard
• Kelli Blanchard, MSW
• Meghan Marie Blanchard, LMSW
• Rachelle Renea Blanchard, PA-C
• Ashley Blanchette, PHARMD

• Clinical Social Worker in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 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.