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Deactivated NPI 1174978191 Deactivated / Inactive NPI Male Practitioner

Robert Philp Blake , LPC #C3517

Counselor - Professional • Brookings, OR

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Robert Blake has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date April 27, 2016
NPI Deactivation Date June 04, 2026
Total Practice Duration ~10 Years of Practice (2016 – 2026)

Professional Overview & Biography Verified Profile Summary

Robert Blake, LPC #C3517 was a registered Counselor - Professional practicing in Brookings, OR. Throughout an active medical career spanning 10 years, Robert Blake provided care at the practice location at 603 HEMLOCK ST until profile deactivation on 2026-06-04.

Practice Location & Contact Primary Location

Practice Address

603 Hemlock St
Suite 2b

Brookings, OR 97415

Telephone 7072181758

Specialty Benchmarks & Practice Insights

Comparative analytics for Counselor - Professional in Brookings, OR

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 13.0 Yrs
State Avg: 13.7 Yrs
Regional Practice Density
7 Specialists

Practicing in Brookings, OR (2601 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Counselor - Professional Primary Specialty

NUCC Taxonomy Code: 101YP2500X

State License OR LPC #C3517

Definition to come...

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners
Nancy Wolf , FNP

Nurse Practitioner - Psychiatric/Mental Health

NPI 1558577569

Family Nurse Practitioner

NPI 1568692739

Doctor of Philosophy (Ph.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated June 04, 2026

Record deactivated on June 04, 2026

NPI Profile Active April 27, 2016

NPI status registered as active in NPPES database

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Updated Practice Location April 27, 2016

Registered at 603 HEMLOCK ST, SUITE 2B, BROOKINGS, OR 97415 (Tel: 7072181758)

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Updated Business Mailing Address April 27, 2016

Registered at P O BOX 175, FORT DICK, CA 95538 (Tel: 7072181758)

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Provider Name / Credentials Updated April 27, 2016

Recorded as ROBERT BLAKE, LPC #C3517

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Medical Taxonomy / Specialty Registered (Primary Specialty) April 27, 2016

Counselor (License #LPC #C3517 in OR)

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Initial NPI Registration & Enumeration April 27, 2016

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1174978191
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 27, 2016
Last Update: April 27, 2016
Deactivation Date: June 04, 2026

Mailing Address

P O Box 175

Fort Dick, CA 95538

Phone: 7072181758

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.