SEAN MICHAEL BLAKE PCC NPI 1366538522

NPI Information

NPI: 1366538522
Provider Name: SEAN MICHAEL BLAKE, PCC
Classification: Counselor - 101Y00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
340 S BROADWAY ST
AKRON, OH
ZIP 44308
Phone: (330) 253-3100
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Sean Michael Blake, PCC is a counselor in Akron, OH. The provider is a provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification. Sean Michael Blake, PCC NPI is 1366538522. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

340 S BROADWAY ST
AKRON, OH
ZIP 44308-529
Phone: (330) 253-3100
Fax: (330) 253-5248

The NPI 1366538522 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 10/5/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101Y00000X	Counselor		E4378	OHIO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	000000388942	OTHER	OHIO	ANTHEM

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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