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Contact Information

NATHANIEL A BLAKE, CFBPPC, LCAS
1230 SAINT MARKS CHURCH RD
BURLINGTON, NC27215-9797
 Phone: 336-227-5476
 Fax: 336-437-1898
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pastoral

101YP1600X
 

Addiction (Substance Use Disorder)

101YA0400X
Indicates primary specialty

NPI Profile & details for NATHANIEL A BLAKE · (Male)

NPI Number 1659889640
Status Active
Credentials CFBPPC, LCAS
Entity Individual
Enumeration date 01/12/2018
Last updated 02/05/2020 - About 6 years ago
Sole proprietor 1 No
Identifiers
  • NC License # 116
  • NC License # 22716
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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