Individual
MR. NATHANIEL ALLEN BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CFBPPC, LCAS
Contact information
Practice address
1230 SAINT MARKS CHURCH RD, BURLINGTON, NC 27215-9797
(336) 227-5476
(336) 437-1898
Mailing address
1230 SAINT MARKS CHURCH RD, BURLINGTON, NC 27215-9797
(336) 227-5476
(336) 437-1898
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
22716
NC
101YP1600X
Pastoral Counselor
Primary
116
NC
Other
Enumeration date
01/12/2018
Last updated
02/05/2020
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