Blake, Virginia L.

Blake, Virginia L. is an individual health care provider with primary practice located at 127 Palmer St , Calais ME 04619-1300. She recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Blake, Virginia L. can be contacted via phone (207) 454-0270.

Contact Information

Primary practice address
127 Palmer St Calais ME 04619-1300
Phone: (207) 454-0270
Fax: (207) 454-0232
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X LC3675 Maine

Profile Details

NPI number 1659638955
LBN Legal business name Blake, Virginia L.
Credentials LADC, CCS, LSW
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 12th, 2012
Last updated Apr 12th, 2012 - about 13 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 1659638955 NPPES
Maine MEDICAID 103850000

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