Anthonette Blake, is a medicare enrolled "Social Worker - Clinical" provider in Ashtabula, Ohio. Her current practice location is
2801 C Ct, Ashtabula, Ohio. You can reach out to her office (for appointments etc.) via phone at
(440) 998-4210.
Anthonette Blake is licensed to practice in Ohio (license number I.2305042) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1891200432.
Healthcare Provider's Profile
| Full Name | Anthonette Blake |
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| Gender | Female |
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| Speciality | Social Worker - Clinical |
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| Location | 2801 C Ct, Ashtabula, Ohio |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1891200432
- Provider Enumeration Date: 12/05/2017
- Last Update Date: 01/03/2024
Medicare PECOS Information:
- PECOS PAC ID: 6800233172
- Enrollment ID: I20240321003199
Medical Identifiers
Medical identifiers for Anthonette Blake such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1891200432 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YM0800X | Counselor - Mental Health | (Ohio) | Secondary |
| 1041C0700X | Social Worker - Clinical | I.2305042 (Ohio) | Primary |
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (Ohio) | Secondary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Anthonette Blake allows following entities to bill medicare on her behalf.
| Entity Name | Community Counseling Center Of Ashtabula County |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1720029622
PECOS PAC ID: 7113830118
Enrollment ID: O20031106000414 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Anthonette Blake is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Anthonette Blake,
2801 C Ct,
Ashtabula, OH 44004-4577
Ph: (440) 998-4210 | Anthonette Blake,
2801 C Ct,
Ashtabula, OH 44004-4577
Ph: (440) 998-4210 |
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