Active NPI
Michael Blake, PSY.D.
- Psychologist
- Stockbridge, MA
National Provider Identifier
1861876963
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 10144
- Practice address
- 25 Main St.
Office 322
Stockbridge, MA 01262-0962 - Phone
- (413) 931-5235
- NPI assigned
- Jul 17, 2015
- Last updated
- Jul 17, 2015
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 10144 | MA | Primary |
Addresses
Primary practice location
25 Main St.
Office 322
Stockbridge, MA 01262-0962
Mailing address
PO Box 962
Stockbridge, MA 01262-0962
Phone (413) 931-5235
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10144 | MA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1437091200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1437091200000",
"number": "1861876963",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 962",
"city": "STOCKBRIDGE",
"state": "MA",
"postal_code": "012620962",
"telephone_number": "413-931-5235"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25 MAIN ST.",
"address_2": "OFFICE 322",
"city": "STOCKBRIDGE",
"state": "MA",
"postal_code": "012620962",
"telephone_number": "413-931-5235"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLAKE",
"first_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-07-17",
"last_updated": "2015-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MA",
"license": "10144",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stockbridge, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.