person
Kevin Blake, PC
Professional Counselor in Cleveland, Ohio
NPI 1215394424

Kevin Blake is a Professional Counselor based in Cleveland, OH and is specialized in Professional. Kevin Blake practices in Cleveland, OH and has the professional credentials of PC. The NPI Number for Kevin Blake is 1215394424 and holds a License No. C1300277 (Ohio).

The current practice location address for Kevin Blake is 4400 Euclid Ave, Cleveland, OH and can be reached out via phone at 216-432-7200 and via fax at 216-432-7253.

Location: 4400 Euclid Ave, Cleveland, OH, 44103-3736
person
Provider Profile Details
NPI Number
1215394424
Provider Name
Kevin Blake
Credential
PC
Provider Entity Type
Individual
Gender
Male
Address
4400 Euclid Ave, Cleveland, OH, 44103-3736
Phone Number
216-432-7200
Fax Number
216-432-7253
Provider Enumeration Date
01/19/2016
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
C1300277 01 OH STATE LICENSE
institution
Provider Business Practice Location Address Details
Address
4400 Euclid Ave
City
State
Zip
44103-3734
Phone Number
216-432-7200
Fax Number
216-432-7253
person
Provider Business Mailing Address Details
Address
4400 Euclid Ave
City
State
Zip
44103-3734
Phone Number
216-432-7200
Fax Number
216-432-7253
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
License No.
C1300277 (Ohio)
Definition
Definition to come...
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