MEDICARE: DR. JAMIE BLALOCK LMFT

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
1	106H00000X	Marriage & Family Therapist	27.003804	CT

General Provider Information

NPI Number	:	1952258378
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMIE BLALOCK LMFT

Provider Business Mailing Address
First Line	:	9 MARION ST.
Second Line	:	APT B
City	:	WESTERLY
State	:	RI
Zip	:	02891
Country	:	US
Telephone Number	:	959-910-1545
Fax Number	:

Provider Business Practice Location Address
First Line	:	9 MARION ST.
Second Line	:	APT B
City	:	WESTERLY
State	:	RI
Zip	:	02891
Country	:	US
Telephone Number	:	959-910-1545
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/13/2026
Last Update Date	:	03/13/2026

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Directions to “ DR. JAMIE BLALOCK LMFT” Practice Location

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