Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mistey Lynn Blake, MATLLPCADC-M

Individual provider Clinical Psychologist · NPI 1821330499

Mistey Lynn Blake, MATLLPCADC-M is a Clinical Psychologist in Canton, Michigan. Licensed in Michigan. Registered with an NPI since 2013.

Licensed in
MI
In the registry since
2013
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Practice location Address checks out

50430 School House Rd 100
Canton, MI 48187-5910
Phone: (734) 495-1722
Fax: (734) 495-3068
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence 6301015297 (MI)

Record details

NPI number1821330499
Entity typeIndividual (Type 1)
GenderFemale
Credentials MATLLPCADC-M
Sole proprietorNo
NPI enumeratedMarch 21, 2013
Last updated in NPPESMarch 21, 2013

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