Healthcare Provider Details

I. General information

NPI: 1689594756
Provider Name (Legal Business Name): UNINTERRUPTED LIFE COLLECTIVE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

189 WIND CHIME CT STE 202
RALEIGH NC
27615-6480
US

IV. Provider business mailing address

137 SKYWAY DR
CLAYTON NC
27527-5119
US

V. Phone/Fax

Practice location:
  • Phone: 984-230-2118
  • Fax: 984-220-9240
Mailing address:
  • Phone: 984-280-0022
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: PASHYON N BLAKE
Title or Position: OWNER/CLINICIAN
Credential: LCSW
Phone: 984-280-0022