Kristy Eleanor Blalock, LCPC, NCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

12860 Issued in MD

Practice address

8028 Ritchie Hwy
Suite 308
Pasadena, MD 21122-1075

Phone

(410) 761-0725

Fax

(410) 761-2412

NPI assigned

Jun 12, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

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.

• Project Chesapeake, LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Annapolis, MD
  • NPI 1134539208
  Medicare reassignment NPD
• University Psychological Center, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Baltimore, MD
  • NPI 1841647617
  Medicare reassignment NPD
• Project Chesapeake, LLC

  • Substance Abuse Rehabilitation Facility
  • East New Market, MD
  • NPI 1104709088
  NPD
• Project Chesapeake, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Annapolis, MD
  • NPI 1174025175
  NPD
• University Psychological Center, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Berwyn Heights, MD
  • NPI 1407507783
  NPD
• Associated Psychotherapists

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Pasadena, MD
  • NPI 1356746952
  NPD (past)

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

{
    "created_epoch": "1339459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405900800000",
    "number": "1922360247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8069 GREEN ORCHARD RD",
            "address_2": "APT 12",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210615115",
            "telephone_number": "443-223-2193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8028 RITCHIE HWY",
            "address_2": "SUITE 308",
            "city": "PASADENA",
            "state": "MD",
            "postal_code": "211221075",
            "telephone_number": "410-761-0725",
            "fax_number": "410-761-2412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLALOCK",
        "first_name": "KRISTY",
        "middle_name": "ELEANOR",
        "credential": "LCPC, NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-12",
        "last_updated": "2014-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MD",
            "license": "12860",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MD",
            "license": "12860",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "12860",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "12860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Alicia Blake-Hall, BSN, RN,RD, CDCES
• Board of Child Care
• Michael David Boblitz, PHARM.D.
• Michael Joseph Bochniewicz, RPH
• Deborah Bodnar
• Ranesa L. Bolander, LCSW-C

• Professional Counselor in Pasadena, MD
• Providers in Pasadena, MD by specialty
• Professional Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2014; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.