JILLISA YVETTE BLAKE CDCA NPI 1912610866

NPI Information

NPI: 1912610866
Provider Name: JILLISA YVETTE BLAKE, CDCA
Classification: Counselor - 101YA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

Address:
819 VENETIAN WAY
GAHANNA, OH
ZIP 43230
Phone: (614) 956-9323
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Jillisa Yvette Blake, CDCA is an addiction (substance use disorder) counselor in Gahanna, OH. Jillisa Yvette Blake, CDCA NPI is 1912610866. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

819 VENETIAN WAY
GAHANNA, OH
ZIP 43230-855
Phone: (614) 956-9323

The enumeration date for this NPI number is 1/5/2023 and was last updated on 1/5/2023.

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	101YA0400X	Counselor	Addiction (Substance Use Disorder)	CDCA.182979	OHIO	Yes

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: 5/5/2024

NPI Synchronization or Removal

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