| Provider / Organization | NPI | Date Certified |
|---|---|---|
| EDDIE LEE BLAKES | 1992311534 | 2020-09-18 |
Eddie Lee Blakes is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1992311534. Registration indicates Eddie Lee Blakes is a provider of access to mental health/behavioral health providers services with a specialization in Behavioral Health & Social Service Providers, Counselor (Behavioral Health & Social Service Providers, Counselor) (Counselor, ) (Behavioral Health/Substance Abuse/Psychiatry, ) (Counselor, Behavioral Health & Social Service Providers) Access to Mental Health/Behavioral Health Providers (Behavioral Health & Social Service Providers, Counselor) (Behavioral Health & Social Service Providers, Counselor) (Counselor: Mental Health, ) (Behavioral Health/Substance Abuse/Psychiatry, ) (Counselor Mental Health, Behavioral Health & Social Service Providers) (Counselor, ) Access to Substance Use Disorder Providers (Behavioral Health & Social Service Providers, Counselor) (Behavioral Health & Social Service Providers, Counselor) (Counselor: Addiction (Substance Use Disorder),, ) (Behavioral Health/Substance Abuse/Psychiatry, ) (Counselor Addiction Substance Use Disorder, Behavioral Health & Social Service Providers) (Counselor, )
| Entity Type | Individual |
| Provider Name | Mr. Eddie Lee Blakes Jr. LISAC |
| Practice Office Address | 1900 W CARLA VISTA DR UNIT 6665 CHANDLER, AZ US |
| Practice Office Telephone | 4805215289 |
| Mailing Address | 1900 W CARLA VISTA DR UNIT 6665 CHANDLER, AZ 852464028 US |
| Business Telephone | 4805215289 |
| Address | City / State | Phone / Fax |
|---|---|---|
| 1802 E Thomas Rd Ste 1 | Phoenix, AZ 850168134 | 6023027800 |
| Main Office [] | www.lifelinePCS.com | Health Information Exchange (HIE) |
| Main Office [] | www.terroshealth.org | Health Information Exchange (HIE) |
| Main Website [] | www.vrpsychservices.com | Health Information Exchange (HIE) |
| Code | Practice | License No State |
|---|---|---|
| 101Y00000X | Access to Mental Health/Behavioral Health Providers Behavioral Health & Social Service Providers Counselor Behavioral Health & Social Service Providers Counselor Counselor Behavioral Health/Substance Abuse/Psychiatry Counselor Behavioral Health & Social Service Providers | LISAC-155298
AZ |
| 101YM0800X | Access to Mental Health/Behavioral Health Providers Behavioral Health & Social Service Providers Counselor Behavioral Health & Social Service Providers Counselor Counselor: Mental Health Behavioral Health/Substance Abuse/Psychiatry Counselor Mental Health Behavioral Health & Social Service Providers Counselor | LISAC-155298
AZ |
| 101YA0400X PRIMARY | Access to Substance Use Disorder Providers Behavioral Health & Social Service Providers Counselor Behavioral Health & Social Service Providers Counselor Counselor: Addiction (Substance Use Disorder), Behavioral Health/Substance Abuse/Psychiatry Counselor Addiction Substance Use Disorder Behavioral Health & Social Service Providers Counselor | LISAC-155298
AZ |