NPI 1417518143 · live from the CMS NPI Registry
Holli Blake, LCSW
Social Worker, Clinical in Wasilla, AK. National Provider Identifier 1417518143, active.
NPI record
| NPI | 1417518143 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Social Worker, Clinical 1041C0700X |
| Practice location | 1001 S Knik Goose Bay Rd, Wasilla, AK 99654 |
| Practice phone | 907-631-7800 |
| Mailing address | 7033 E Tudor Rd, Anchorage, AK 99507 |
| Enumerated | June 24, 2019 |
| Last updated | January 7, 2025 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Social Worker, Clinical primary | 1041C0700X | 155725 (AK) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.