Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1164627006 Individual Practitioner Female Practitioner

Maribeth Blake , MSCCC-SLP

Speech-Language Pathologist • Green Bay, WI

Professional Overview & Biography Verified Profile Summary

Maribeth Blake, MSCCC-SLP is a registered healthcare professional specializing in Speech-Language Pathologist in Green Bay, WI. Practice services are available at 2801 S WEBSTER AVE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

2801 S Webster Ave

Green Bay, WI 543012878

Telephone 9203371122
Associated Practice Facility / Clinic
🏢 Cerebral Palsy, Inc. Facility NPI 1548216484

Specialty Benchmarks & Practice Insights

Comparative analytics for Speech-Language Pathologist in Green Bay, WI

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 12.1 Yrs
State Avg: 12.9 Yrs
Regional Practice Density
125 Specialists

Practicing in Green Bay, WI (3821 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

Speech-Language Pathologist Primary Specialty

NUCC Taxonomy Code: 235Z00000X

State License WI 1043-154

The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
42717700 (WI)
Commercial Insurance / Payer ID State License
1043-154 (WI)

Practice Associates & Co-Workers

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

29 Associated Practitioners
Lynn Jadin , OTR

Occupational Therapist

NPI 1033315387

Occupational Therapist Registered

Lisa Olson , MS CCC-SLP

Speech-Language Pathologist

NPI 1053517276

MSCCCSLP

Tanya Vincent

Speech-Language Pathologist

NPI 1053518860
Mikaila Fager , MS, SLP-CCC

Speech-Language Pathologist

NPI 1083289110

Master of Science, SLPCCC

Patricia Stegeman-Frank , PT

Physical Therapist - Pediatrics

NPI 1093911315

Physical Therapist

Mary Gantz , PT

Physical Therapist

NPI 1114122801

Physical Therapist

Career & Practice History Timeline

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

6 Historical Events
NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location July 08, 2007

Registered at 2801 S WEBSTER AVE, GREEN BAY, WI 543012878 (Tel: 9203371122)

📍
Updated Business Mailing Address July 08, 2007

Registered at 1527 GJERPEN LN, MANITOWOC, WI 542209765

👤
Provider Name / Credentials Updated July 08, 2007

Recorded as MARIBETH BLAKE, M.S.CCC-SLP

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Speech-Language Pathologist (License #1043-154 in WI)

🟢
Initial NPI Registration & Enumeration June 20, 2007

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: 1164627006
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 20, 2007
Last Update: July 08, 2007
Sole Proprietor: No

Mailing Address

1527 Gjerpen Ln

Manitowoc, WI 542209765

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.