Tiffany Nichole Blake, is a
Counselor - Mental Health based in S Salt Lake, Utah. Tiffany Nichole Blake is licensed to practice in * (Not Available) (license number ) and her current practice location is
447 W Bearcat Dr, S Salt Lake, Utah. She can be reached at her office (for appointments etc.) via phone at
(801) 355-2846.
NPI number for Tiffany Nichole Blake is 1073042842 and her current mailing address is 447 W Bearcat Dr, S Salt Lake, Utah. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1073042842.
Healthcare Provider's Profile
Full Name | Tiffany Nichole Blake |
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Gender | Female |
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Speciality | Counselor - Mental Health |
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Location | 447 W Bearcat Dr, S Salt Lake, Utah |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1073042842
- Provider Enumeration Date: 06/06/2017
- Last Update Date: 07/21/2022
Medical Identifiers
Medical identifiers for Tiffany Nichole Blake such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1073042842 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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. Tiffany Nichole Blake is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Tiffany Nichole Blake, 447 W Bearcat Dr, S Salt Lake, UT 84115-2519 Ph: (801) 355-2846 | Tiffany Nichole Blake, 447 W Bearcat Dr, S Salt Lake, UT 84115-2519 Ph: (801) 355-2846 |
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