SHAWNTAE MONIQUE BLAKE LCPC
NPI 1780450114
Counselor - Professional in Salisbury, MD
About Shawntae Monique Blake Lcpc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SHAWNTAE MONIQUE BLAKE LCPC (NPI 1780450114) is an individual professional provider in Salisbury, Maryland, licensed in Maryland (LC17199) and active in the NPI registry since November 2023. She is enrolled in Medicare PECOS and is a graduate of Other (2022).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Shawntae Monique Blake Lcpc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Shawntae Blake reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Berlin, MD 21811
- Reassigned Medicare billing, Maryland enrollment
- 14 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Shawntae Blake's NPI number?
The NPI number for Shawntae Blake is 1780450114. It was assigned to this individual provider in the NPPES registry on November 28, 2023.
Where is Shawntae Blake located?
Shawntae Blake practices at 100 E Main St Ste 502, Salisbury, MD 21801. The listed phone number is (667) 281-0094.
What is Shawntae Blake's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.
Is Shawntae Blake enrolled in Medicare?
Yes. Shawntae Blake is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Shawntae Blake's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Shawntae Blake reassigns Medicare benefits to Lighthouse Counseling Christian Ministry, LLC (Berlin, MD). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Shawntae Blake's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Shawntae Blake was last updated on June 23, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months 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.
# Shawntae Monique Blake, LCPC · NPI 1780450114
Professional provider in Salisbury, Maryland. Individual provider, active in the CMS NPPES registry since November 28, 2023.
## Identity
- **NPI:** 1780450114 (Entity type: Individual)
- **Enumerated:** November 28, 2023
- **Primary specialty:** Counselor - Professional · taxonomy 101YP2500X
- **State license:** LC17199 (Maryland)
- **Sole proprietor:** No
## Practice location
- **Address:** 100 E MAIN ST STE 502, Salisbury, MD 21801-5079
- **Phone:** (667) 281-0094
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Lighthouse Counseling Christian Ministry, LLC (NPI 1104272426, Berlin, MD), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2022
## Record status
- **NPPES last updated:** June 23, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1780450114) · Data from the CMS NPPES public registry.