Stephanie Blalock
Individual provider Active NPI Mental Health Counselor · Marina, CA
NPI 1972036499 · NPPES record last updated Apr 11, 2017
Key facts
- NPI
- 1972036499
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- Practice address
- 617 Bayonet Circle
Marina, CA 93933 - Phone
- (831) 384-7251
- NPI assigned
- Apr 11, 2017
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Yes |
Addresses
Primary practice location
617 Bayonet Circle
Marina, CA 93933
Mailing address
617 Bayonet Circle
Marina, CA 93933
Phone (831) 384-7251
Other providers in Marina, CA
- Jose Beltran
- Samuel Mark Bernhisel
- Gabriela Berteaud
- Mary Black
- Melissa Katherine Black
- Mena Boules
- April Brazinsky
- Kassie Brewer
- Bridge Community Services of Ca
- Erica Briones-Reyes
All providers in Marina, CA · Mental Health Counselor in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 11, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.