Blake, Nicole E

Blake, Nicole E is an sole proprietor health care provider with primary practice located at 40 Brackett St Apt 3 , Westbrook ME 04092-3383. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Blake, Nicole E can be contacted via phone (603) 860-4900.

Contact Information

Primary practice address
40 Brackett St Apt 3 Westbrook ME 04092-3383
Phone: (603) 860-4900
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X LC7566 Maine
Behavioral Health & Social Service Providers / Clinical 1041C0700X 2905 New Hampshire
Behavioral Health & Social Service Providers / Clinical 1041C0700X LC21397 Maine

Profile Details

NPI number 1962022350
LBN Legal business name Blake, Nicole E
Credentials LCSW, LADC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 25th, 2020
Last updated Oct 30th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1962022350 NPPES
Other 2077079813 INDIV NPI

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