Lancaster, Blake M

Lancaster, Blake M is an individual health care provider with primary practice located at 1500 E Medical Center Dr , Ann Arbor MI 48109-5000. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Clinical Child & Adolescent. Behavioral Health & Social Service Providers / Clinical Child & Adolescent is his primary health care specialty. Lancaster, Blake M can be contacted via phone (734) 936-4000.

Contact Information

Primary practice address
1500 E Medical Center Dr Ann Arbor MI 48109-5000
Phone: (734) 936-4000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 6301015156 Michigan
Behavioral Health & Social Service Providers / Clinical 103TC0700X PLP302 Nebraska
Behavioral Health & Social Service Providers / Clinical Child & Adolescent 103TC2200X 6301015156 Michigan

Profile Details

NPI number 1255521787
LBN Legal business name Lancaster, Blake M
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 31st, 2007
Last updated Nov 11th, 2020 - about 4 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 1255521787 NPPES
Nebraska MEDICAID 302

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