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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: August 09, 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, maintains a secondary practice location in Winston Salem, and is a graduate of Other (2022).

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
Medical School CMSOtherGraduated 2022
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
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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).

PECOS PAC ID6103318514
PECOS Enrollment IDI20251124001225
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.

MICHELE COPELAND STANSELL
Community/Behavioral Health
1301 NATIONAL HWY
THOMASVILLE, NC 27360
Davidson County (336) 472-8230
MERCEDES IMANI GARNER
Community/Behavioral Health
1301 NATIONAL HWY
THOMASVILLE, NC 27360
Davidson County (336) 472-8230
CLERCIFIE LENEUS MS
Counselor (Addiction (Substance Use Disorder))
1301 NATIONAL HWY
THOMASVILLE, NC 27360
Davidson County (336) 472-8230
ALEWAH I OUTLAW
Counselor (Addiction (Substance Use Disorder))
1301 NATIONAL HWY
THOMASVILLE, NC 27360
Davidson County (336) 472-8230
VERA K LLOYD
Community/Behavioral Health
1301 NATIONAL HWY
THOMASVILLE, NC 27360
Davidson County (336) 472-8230
ALLISON PAIGE BLANKENSHIP
Registered Nurse (Addiction (Substance Use Disorder))
1301 NATIONAL HWY
THOMASVILLE, NC 27360
Davidson County (336) 472-8230
MRS. TRACY BYRD BARROW LPN
Community/Behavioral Health
1301 NATIONAL HWY
THOMASVILLE, NC 27360
Davidson County (336) 472-8230
MISS TARA R SMITH BSW, CDAC
Counselor (Addiction (Substance Use Disorder))
1301 NATIONAL HWY
THOMASVILLE, NC 27360
Davidson County (336) 462-8230

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jacquelyn Blake's NPI number?

The NPI number for Jacquelyn Blake is 1285355453. It was assigned to this individual provider in the NPPES registry on September 7, 2022.

Where is Jacquelyn Blake located?

Jacquelyn Blake practices at 1301 National Hwy, Thomasville, NC 27360. The listed phone number is (336) 472-8230.

What is Jacquelyn Blake's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

Is Jacquelyn Blake enrolled in Medicare?

Yes. Jacquelyn Blake is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jacquelyn Blake was last updated on September 7, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.