1. Home
  2. Directory
  3. North Carolina
  4. Thomasville
  5. Counselor
  6. NPI Profile

JACQUELYN BLAKE
NPI 1285355453
Counselor - Addiction (Substance Use Disorder) in Thomasville, NC

Active since September 07, 2022PECOS Enrolled
1301 NATIONAL HWY, THOMASVILLE, NC 27360(336) 472-8230 Get Directions Write a Review

NPPES record last updated: September 7, 2022. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Jacquelyn Blake NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACQUELYN BLAKE (NPI 1285355453) is an individual addiction (substance use disorder) provider in Thomasville, North Carolina and active in the NPI registry since September 2022. She is enrolled in Medicare PECOS and maintains a secondary practice location in Winston Salem.

NPPES Registry Identity

NPI1285355453
Entity TypeIndividualFemale
Primary Taxonomy101YA0400X
Provider Legal NameJACQUELYN BLAKE
Location Address1301 NATIONAL HWYThomasville, NC 27360-2317
Mailing Address1301 National HwyThomasville, NC 27360-2317
Phone(336) 472-8230
Sole ProprietorYes
Enumeration DateSeptember 7, 2022
NPPES CertifiedSeptember 7, 2022
✔ NPI 1285355453 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
1301 NATIONAL HWY, Thomasville, NC 27360
Open in Google Maps ↗

Secondary Practice Location 1

Location 13335 Piedmont Memorial DrWinston Salem, NC 27107-4569 · Phone (336) 997-2257

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jacquelyn Blake is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

FORSYTH MEMORIAL HOSPITAL, INC
Family Medicine
1301 NATIONAL HWY
THOMASVILLE, NC 27360
Davidson County (336) 474-1002
RHEANNON LEE VARKER
Community/Behavioral Health
1301 NATIONAL HWY
THOMASVILLE, NC 27360
Davidson County (336) 472-8230
KELLI NICOLE RAGAN
Community/Behavioral Health
1301 NATIONAL HWY
THOMASVILLE, NC 27360
Davidson County (336) 472-8230
MICHELE COPELAND STANSELL
Community/Behavioral Health
1301 NATIONAL HWY
THOMASVILLE, NC 27360
Davidson County (336) 472-8230
JANA KAISER RICHTER
Community/Behavioral Health
1301 NATIONAL HWY
THOMASVILLE, NC 27360
Davidson County (336) 472-8231
VERA K LLOYD
Community/Behavioral Health
1301 NATIONAL HWY
THOMASVILLE, NC 27360
Davidson County (336) 472-8230
ERIC BASS
Community/Behavioral Health
1301 NATIONAL HWY
THOMASVILLE, NC 27360
Davidson County (336) 472-8230
MR. JOHN THOMAS STEVENSON III RN
Community/Behavioral Health
1301 NATIONAL HWY
THOMASVILLE, NC 27360
Davidson County (336) 472-8230

Frequently Asked Questions

What is Jacquelyn Blake's NPI number?

The NPI number assigned to this healthcare provider is 1285355453, enumerated as an "individual" on September 07, 2022.

Where is the provider located?

The provider is located at 1301 NATIONAL HWY THOMASVILLE, NC 27360 and the phone number is (336) 472-8230.

What is the provider's specialty?

Counselor with taxonomy code 101YA0400X and a focus in Addiction (Substance Use Disorder).