NPI
Blaq Therapy
NPI 1609646256
Read from the NPPES registry on October 23, 2026.
Facts
- Status
- Active
- Type
- Organization
- Enumeration date
- 2024-01-04
- Last updated
- 2024-01-04
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Specialties
- 101YP2500XCounselor, Professional · Primary
- 101YM0800XCounselor, Mental Health
- 103TC1900XPsychologist, Counseling
- 1041C0700XSocial Worker, Clinical
- 163WP0808XRegistered Nurse, Psych/Mental Health
- 2084P0800XPsychiatry & Neurology, Psychiatry
- 221700000XArt Therapist
- 225A00000XMusic Therapist
- 363LP0808XNurse Practitioner, Psych/Mental Health
- 364SP0808XClinical Nurse Specialist, Psych/Mental Health
Licenses
The registry row did not include a license.
Location
- Practice location
- 24073 Crescent St
- City
- Mattawan MI
- Postal code
- 49071-8457
- Phone
- (734) 802-7667
Organization contact
- Name
- Anter Abdallah
- Title
- Credentialer
- Phone
- (734) 802-7667
Medicare
- PECOS
- No PECOS enrollment row matched this NPI.
LEIE
No exclusion found for this NPI in the OIG LEIE file dated October 9, 2026. Confirm on OIG's online search.
Nearby
Other NPIs in Mattawan, MI. 137 records in the public file.
Public data from NPPES and CMS. Not a credentialing determination.
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