Active NPI
Anathaleo Blake, B.A.
- Addiction (Substance Use Disorder) Counselor
- Bronx, NY
National Provider Identifier
1992101141
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 38640-T
- Practice address
- 3584 Jerome Ave
Bronx, NY 10467-1006 - Phone
- (718) 653-1537
- Fax
- (718) 228-6993
- NPI assigned
- Nov 17, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 38640-T | NY | Primary |
| Social Worker | 104100000X |
Addresses
Primary practice location
3584 Jerome Ave
Bronx, NY 10467-1006
Mailing address
79 Glenridge Rd
Glenville, NY 12302-4523
Other practice location 1
9114 37th Ave
Jackson Heights, NY 11372-7920
Phone (718) 779-1831
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
- Credentials
- Bachelor of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 38640-T | NY | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1416182400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724198400000",
"number": "1992101141",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "79 GLENRIDGE RD",
"city": "GLENVILLE",
"state": "NY",
"postal_code": "123024523"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3584 JEROME AVE",
"city": "BRONX",
"state": "NY",
"postal_code": "104671006",
"telephone_number": "718-653-1537",
"fax_number": "718-228-6993"
}
],
"practiceLocations": [
{
"address_1": "9114 37th Ave",
"address_purpose": "LOCATION",
"city": "Jackson Heights",
"state": "NY",
"postal_code": "113727920",
"country_code": "US",
"telephone_number": "718-779-1831",
"fax_number": "347-612-4150",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BLAKE",
"first_name": "ANATHALEO",
"name_prefix": "Mr.",
"credential": "B.A.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-11-17",
"last_updated": "2024-08-21",
"certification_date": "2024-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NY",
"license": "38640-T",
"primary": true
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.