NPI 1407322092 · live from the CMS NPI Registry
Jesse L Blake, MSW, LISW, LCSW
Social Worker, Clinical in Wooster, OH. National Provider Identifier 1407322092, active.
NPI record
| NPI | 1407322092 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Social Worker, Clinical 1041C0700X |
| Practice location | 2000 Noble Dr, Wooster, OH 44691 |
| Practice phone | 330-264-3232 |
| Enumerated | October 22, 2018 |
| Last updated | August 7, 2024 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Social Worker, Clinical primary | 1041C0700X | I.2405108 (OH) |
| Social Worker | 104100000X | S.1800525-TRNE (OH) |
| Social Worker | 104100000X | S.2005362 (OH) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.