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NPI Code Detail

MEDICARE: ALEXIS P BLAKE LPC

MEDICARE: ALEXIS P BLAKE LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional CounselorC.2406685OH

General Provider Information

NPI Number : 1780498477
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEXIS P BLAKE LPC
Provider Business Mailing Address
First Line : 5000 ARLINGTON CENTRE BLVD # 9B
Second Line :
City : COLUMBUS
State : OH
Zip : 43220-3075
Country : US
Telephone Number : 614-665-0665
Fax Number :
Provider Business Practice Location Address
First Line : 5000 ARLINGTON CENTRE BLVD # 9B
Second Line :
City : COLUMBUS
State : OH
Zip : 43220-3075
Country : US
Telephone Number : 614-665-0665
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/04/2025
Last Update Date : 04/20/2026

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