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General NPI Number Information
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NPI Number | 1366106783
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Entity Type | Organization
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Legal Business Name | BLAKES COUNSELING & CONSULTING, LLC
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Dates
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Enumeration Date | 10/22/2021
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Last Update Date | 10/22/2021
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Provider Practice Location Address
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Address Line | 2112 11TH AVE S STE 325
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City | BIRMINGHAM
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State | AL
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Zip | 35205-2845
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Country | US
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Telephone | 205-876-9076
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 26331
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City | BIRMINGHAM
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State | AL
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Zip | 35260-0331
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Country | US
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Telephone | 205-876-9076
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Fax |
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Authorized Official
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Title or Position | OWNER/LICENSED COUNSELOR
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Name | CARA L. BLAKES
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Credential | LPC, NCC, BC-TMH
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Telephone | 205-876-9076
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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