Individual provider · Type 1 NPI

Mickia Ticre Blake

Mental Health Counselor · Port St. Lucie, FL

NPI number 1841813201 Active

Practice location

540 NW University Blvd Ste 204
Port St. Lucie, FL 34986-2281

Call (561) 216-5711 Map

Other practice locations

  • 4355 3rd Ave N, St. Petersburg, FL 33713-7305 · (908) 783-4403

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XIMH28976

Mental Health Counselor: Definition to come...

11 other providers at this address

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About NPI 1841813201

Mickia Ticre Blake's National Provider Identifier is 1841813201, issued on May 20, 2020. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Port St. Lucie, FL. The record was last updated on Jun 12, 2026.