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

Etosha Blank

Individual provider Professional Counselor · NPI 1780222869

Etosha Blank is a Mental Health Counselor in Brooklyn, New York. Qualified in 2019, 7 years ago. Practices with Talkspace Medical Services Ny PC, a 46-clinician group, accepts Medicare assignment and offers telehealth. Licensed in North Carolina and New York.

Years since qualifying
7
Licensed in
NC, NY
In the registry since
2019
Specialties on file
4
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Practice location Address checks out

705 Manhattan Ave
Brooklyn, NY 11222-2909
Phone: (347) 474-8464
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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 · Licence 012547 (NY)
Professional Counselor Taxonomy 101YP2500X · Licence 23138 (NC)
Mental Health Counselor Taxonomy 101YM0800X · Licence 23138 (NC)
Professional Counselor Taxonomy 101YP2500X · Licence 012547 (NY)

Record details

NPI number1780222869
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedDecember 19, 2019
Last updated in NPPESJuly 1, 2026
Certification dateJuly 1, 2026
Mailing address1021 Windrace Trl, Sanford, NC 27332-8029

Medicare enrollment

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

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Talkspace Medical Services Ny Pc — 46 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Brooklyn