Kimberley Blake, MA, NCC, LPC in Bridgeport, CT

Kimberley Blake, MA, NCC, LPC is a medicare enrolled "Counselor - Professional" provider in Bridgeport, Connecticut. Her current practice location is 140 John St, Bridgeport, Connecticut. You can reach out to her office (for appointments etc.) via phone at (203) 450-9944.

Kimberley Blake is licensed to practice in Connecticut (license number 004945) 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 1922771765.

Contact Information

	Kimberley Blake, MA, NCC, LPC
	140 John St, Bridgeport, CT 06604-4323
	(203) 450-9944
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Kimberley Blake
Gender	Female
Speciality	Counselor - Professional
Location	140 John St, Bridgeport, Connecticut
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1922771765
Provider Enumeration Date: 07/28/2021
Last Update Date: 07/28/2021

Medicare PECOS Information:

PECOS PAC ID: 9638521958
Enrollment ID: I20240122004091

Medical Identifiers

Medical identifiers for Kimberley Blake such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1922771765	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YP2500X	Counselor - Professional	004945 (Connecticut)	Primary

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. Kimberley Blake allows following entities to bill medicare on her behalf.

Entity Name	Cornell Scott Hill Health Corporation
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1902921380 PECOS PAC ID: 3072418359 Enrollment ID: O20031201000145

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. Kimberley 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
Kimberley Blake, MA, NCC, LPC 140 John St, Bridgeport, CT 06604-4323 Ph: (203) 450-9944	Kimberley Blake, MA, NCC, LPC 140 John St, Bridgeport, CT 06604-4323 Ph: (203) 450-9944

Reviews and Comments

Counselor in Bridgeport, CT

Mrs. Jacqueline Rodriguez, LADC,CAC,APP Counselor Medicare: Not Enrolled in Medicare Practice Location: 243 Success Ave, Bridgeport, CT 06610 Phone: 203-864-8429
Ms. Trisha J Coombs, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1120 Main St, Bridgeport, CT 06604 Phone: 203-368-9755 Fax: 203-368-9760
Regine Toussaint, LPC-A Counselor Medicare: Not Enrolled in Medicare Practice Location: 4699 Main St Ste 210, Bridgeport, CT 06606 Phone: 120-320-8394
Rudolph Hagwood Jr., Counselor Medicare: Not Enrolled in Medicare Practice Location: 1635 Fairfield Ave, Bridgeport, CT 06605 Phone: 203-335-3518 Fax: 203-382-5589
Rashawna D Brown, LMSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 324 Bunnell St, Bridgeport, CT 06607 Phone: 475-988-6885
Ms. Kathleen L. Manalis, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1046 Fairfield Ave, Bridgeport, CT 06605 Phone: 203-330-6054 Fax: 203-331-4716
Marcela Haendler, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 475 Clinton Ave, Bridgeport, CT 06605 Phone: 203-368-4291 Fax: 203-368-9167

Kimberley Blake, MA, NCC, LPC - Medicare Counselor in Bridgeport, CT