Provider Demographics
NPI:1881051613
Name:BLAKES, CARA L (LPC, NCC, BC-TMH)
Entity type:Individual
Prefix:
First Name:CARA
Middle Name:L
Last Name:BLAKES
Suffix:
Gender:F
Credentials:LPC, NCC, BC-TMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 26331
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35260-0331
Mailing Address - Country:US
Mailing Address - Phone:205-876-9076
Mailing Address - Fax:
Practice Address - Street 1:2112 11TH AVE S STE 325
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35205-2845
Practice Address - Country:US
Practice Address - Phone:205-876-9076
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-25
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3805101Y00000X, 101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health