Brooke Mackenzie Blakeman, M.ED., BCBA, LBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

BEH-000484 Issued in AZ

Practice address

7600 N 16TH St Ste 110
Phoenix, AZ 85020-4446

Phone

(602) 368-3282

NPI assigned

Nov 4, 2019

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

State licenses

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

{
    "created_epoch": "1572825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572825600000",
    "number": "1962046870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7600 N 16TH ST STE 110",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850204446",
            "telephone_number": "602-368-3282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7600 N 16TH ST STE 110",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850204446",
            "telephone_number": "602-368-3282"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7600 N 16th St Ste 110",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850204446",
            "country_code": "US",
            "telephone_number": "602-368-3282",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLAKEMAN",
        "first_name": "BROOKE",
        "middle_name": "MACKENZIE",
        "credential": "M.ED., BCBA, LBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-04",
        "last_updated": "2019-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "AZ",
            "license": "BEH-000484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Perry Blake, PSYD
• Nadia R Blake
• Raymond Blake III
• Thomas James Blake
• Tyanna Leigh Blake, R.T.(R)
• Doris Blakes-Greenway, ED.D.,OTRL
• Rachel Ewing Blakey, OT
• Jessica Blakley, DO
• Sarah Michelle Blalock
• Carol Blanc, OTR/L CDRS

• Behavior Analyst in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Behavior Analyst in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2019; 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.