Individual
ANNE H BLAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHC, LADC, ATR-BC
Contact information
Practice address
12 WALNUT ST APT 9, NATICK, MA 01760-3564
(617) 543-3652
Mailing address
12 WALNUT ST APT 9, NATICK, MA 01760-3564
(617) 543-3652
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1397
MA
101YM0800X
Mental Health Counselor
Primary
5096
MA
221700000X
Art Therapist
05-147
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LM1250
BLUE CROSS/BLUE SHIELD ID
MA
Enumeration date
09/20/2006
Last updated
02/19/2018
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