Charles Alan Blickle, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH17357 Issued in FL

Practice address

3004 34TH St SW
Lehigh Acres, FL 33976-4542

Phone

(239) 327-1597

NPI assigned

Feb 24, 2023

Sex

Male

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

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Grow Healthcare Group PAGroup PAC ID 3476961368, 1,045 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1677196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677196800000",
    "number": "1871292276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3004 34TH ST SW",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339764542",
            "telephone_number": "239-327-1597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3004 34TH ST SW",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339764542",
            "telephone_number": "239-327-1597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLICKLE",
        "first_name": "CHARLES",
        "middle_name": "ALAN",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-02-24",
        "last_updated": "2023-02-24",
        "certification_date": "2023-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH17357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyssa Amanda Blanco Batista
• Zulema Blanco Mantilla
• Maria D Blanco, DDS
• Latongella Terell Bland, RN
• Bless Medical Center of Lehigh LLC
• Bliss Life Residential Care
• Blissful Care Services LLC
• Blu Gem Supportive Services LLC
• Blue Horizon Professional Group, Inc
• Audrey F Blumenfeld, MPH.,RD

• Mental Health Counselor in Lehigh Acres, FL
• Providers in Lehigh Acres, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.