Active NPI
Anne E Blake-Nickels, BS, BA, AAC
- Counselor
- Vancouver, WA
National Provider Identifier
1851073456
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- CG1472208
- Practice address
- 2502 E 4TH Plain Blvd
Vancouver, WA 98661-3965 - Phone
- (360) 831-0904
- NPI assigned
- Aug 2, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | CG1472208 | WA | Primary |
Addresses
Primary practice location
2502 E 4TH Plain Blvd
Vancouver, WA 98661-3965
Mailing address
PO Box 34703
Seattle, WA 98124-1703
Phone (206) 764-0502
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
- Credentials
- Bachelor of Arts, Bachelor of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CG1472208 | WA | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1690934400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1690934400000",
"number": "1851073456",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 34703",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981241703",
"telephone_number": "206-764-0502",
"fax_number": "206-764-0516"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2502 E 4TH PLAIN BLVD",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986613965",
"telephone_number": "360-831-0904"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLAKE-NICKELS",
"first_name": "ANNE",
"middle_name": "E",
"credential": "BS, BA, AAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-08-02",
"last_updated": "2023-08-02",
"certification_date": "2023-08-02",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "WA",
"license": "CG1472208",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vancouver, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.