Healthcare Provider Details

I. General information

NPI: 1235237009
Provider Name (Legal Business Name): ANNE BLAKE LMHC, LADC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ANNE HORGOS LMHC, LADC

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 ATWATER PL
WEST BROOKFIELD MA
01585-2739
US

IV. Provider business mailing address

17 ATWATER PL
WEST BROOKFIELD MA
01585-2739
US

V. Phone/Fax

Practice location:
  • Phone: 617-543-3652
  • Fax:
Mailing address:
  • Phone: 617-543-3652
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number5096
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number1397
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: