Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Blake Malloy

Individual provider Mental Health Counselor · NPI 1033636519

Blake Malloy is a Mental Health Counselor in Maple Grove, Minnesota. Qualified in 2009, 17 years ago. Practices with Stone Arch Psychology and Health Services, a 7-clinician group.

Years since qualifying
17
In the registry since
2017
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Practice location Address checks out

13603 80th Cir N
Maple Grove, MN 55369-8961
Phone: (763) 274-3120
Fax: (763) 274-3121
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X

Record details

NPI number1033636519
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedAugust 25, 2017
Last updated in NPPESAugust 25, 2017
Mailing address1900 Silver Lake Rd Nw Ste 110, New Brighton, MN 55112-1789

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2009 (17 years in practice)
Group practice Stone Arch Psychology And Health Services — 7 clinicians
Accepts Medicare assignment Not indicated

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