Provider Demographics
NPI:1790108983
Name:ENGELMAN, BLAKE (MA, LPC)
Entity Type:Individual
Prefix:
First Name:BLAKE
Middle Name:
Last Name:ENGELMAN
Suffix:
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1931 BOISE AVE STE 211
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-4297
Mailing Address - Country:US
Mailing Address - Phone:214-492-3296
Mailing Address - Fax:
Practice Address - Street 1:1931 BOISE AVE STE 211
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-4297
Practice Address - Country:US
Practice Address - Phone:214-492-3296
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-24
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX68176101YM0800X
COLPC.0013480101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health