Individual provider Active NPI

Blake Towe, LICSW

  • Clinical Social Worker
  • Huntsville, AL
National Provider Identifier
1992170492
Registry record updated Jul 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
475 Providence Main St NW Ste 401
Huntsville, AL 35806-4818
Phone
(256) 341-0811
Fax
(256) 341-9358
NPI assigned
Dec 9, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 4848C AL
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

475 Providence Main St NW Ste 401
Huntsville, AL 35806-4818

Mailing address

PO Box 988
Decatur, AL 35602-0988
Phone (256) 341-0811

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, MS2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20211027002497 AL Practitioner - Clinical Social Worker 3476941253 Reassigns benefits to 1 organization
I20230929000642 MS Practitioner - Clinical Social Worker 3476941253 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eagle Consulting, LLCGroup PAC ID 6608108824, 6 clinicians

Practice addresses (Care Compare)

475 Providence Main St NW
Suite 401
Huntsville, AL 35806-4818
Phone (256) 341-0811

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Eagle Consulting, LLC Clinical CurrentSince Apr 1, 2024 Accepting new patients
PW-Hospital Bridge Services, LLC PastSince Sep 1, 2021 Accepting new patients

Locations

475 Providence Main St NW
Ste 401
Huntsville, AL 35806
Phone (256) 341-0811

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1449619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722297600000",
    "number": "1992170492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 988",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356020988",
            "telephone_number": "256-341-0811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 PROVIDENCE MAIN ST NW STE 401",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358064818",
            "telephone_number": "256-341-0811",
            "fax_number": "256-341-9358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOWE",
        "first_name": "BLAKE",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-12-09",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AL",
            "license": "4848C",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

Verify at the official NPI Registry.