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

Jacquelyn Blake

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1285355453

Jacquelyn Blake is an Undefined Non-Physician Type (Specify) in Thomasville, North Carolina. Qualified in 2022, 4 years ago. Practices as a sole proprietor and works from 2 locations.

Years since qualifying
4
In the registry since
2022

Practice location Address checks out

1301 National Hwy
Thomasville, NC 27360-2317
Phone: (336) 472-8230
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 3335 Piedmont Memorial Dr, Winston Salem, NC 27107-4569 — (336) 997-2257

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X

Record details

NPI number1285355453
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedSeptember 7, 2022
Last updated in NPPESSeptember 7, 2022
Certification dateSeptember 7, 2022
Mailing address1301 National Hwy, Thomasville, NC 27360-2317

Medicare enrollment

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

Medicare specialtyUNDEFINED NON-PHYSICIAN TYPE (SPECIFY)
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Accepts Medicare assignment Not indicated
Practice locations3 on file with Medicare

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