Blake, Robert R.

Blake, Robert R. is an sole proprietor health care provider with primary practice located at 8433 Harcourt Rd Suite 200, Indianapolis IN 46260-2190. He recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Health Service, Behavioral Health & Social Service Providers / Psychologist. Behavioral Health & Social Service Providers / Psychologist is his primary health care specialty. Blake, Robert R. can be contacted via phone (317) 338-4692.

Contact Information

Primary practice address
8433 Harcourt Rd Suite 200 Indianapolis IN 46260-2190
Phone: (317) 338-4692
Fax: (317) 338-4693
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 20040385 Indiana
Behavioral Health & Social Service Providers / Health Service 103TH0100X 20040385 Indiana
Behavioral Health & Social Service Providers / Psychologist 103T00000X 20040385 Indiana

Profile Details

NPI number 1457387466
LBN Legal business name Blake, Robert R.
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 23rd, 2006
Last updated Nov 25th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1457387466 NPPES
Indiana Other 000000184454 ANTHEM/ BC PROVIDER #
Indiana MEDICAID 100131760A ANTHEM/ BC PROVIDER #

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