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

Timothy G Blake, LP

Individual provider Psychologist · NPI 1568796613

Timothy G Blake, LP is a Clinical Psychologist in Minneapolis, Minnesota. Qualified in 1994, 32 years ago. Practices with Allina Health System, a 3,867-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Minnesota.

Years since qualifying
32
Licensed in
MN
In the registry since
2009
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Practice location Address checks out

2649 Park Ave
Minneapolis, MN 55407-1006
Phone: (612) 676-1604
Fax: (612) 379-8235
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychologist (primary) Taxonomy 103T00000X · Licence 5115 (MN)

Record details

NPI number1568796613
Entity typeIndividual (Type 1)
GenderMale
Credentials LP
Sole proprietorYes
NPI enumeratedSeptember 22, 2009
Last updated in NPPESMarch 11, 2021
Certification dateMarch 11, 2021
Mailing address2649 Park Ave, Minneapolis, MN 55407-1006

Medicare enrollment

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

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 1994 (32 years in practice)
Group practice Allina Health System — 3867 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

Other providers in Minneapolis