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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

JUSTIN LARON BLAKE, LCSW

Active Sole Proprietor

JUSTIN LARON BLAKE, LCSW is a Clinical Social Worker healthcare provider located in ELLENWOOD, Georgia. NPI 1932821956 is currently active in the NPPES registry. Verify at CMS.

Clinical Social Worker · ELLENWOOD, GA

Registration Details

NPI Number
1932821956
Provider Type
Individual
Gender
Male
NPI Issued
Sep 15, 2022 (3.8820615112039 yrs)
Last Updated
Sep 15, 2022
Licenses
CSW007974 (GA)
SW17317 (FL)
Sole Proprietor
Yes

Practice Information

Address
2393 BOULDER CHASE DR
ELLENWOOD, GA, 302941687
Browse GA providers · Browse ZIP 30294
Phone
3059727007
Primary Specialty
Clinical Social Worker
1041C0700X
Additional Specialty
Clinical Social Worker

Other Clinical Social Worker Providers in ELLENWOOD, GA

Name Credential NPI
MS. ALIEIZORIA REDD LCSW 1417973199
MRS. DARNYCE HOUSE HILL LCSW 1902979677
LOUANNA ADAMS LCSW 1033590658
SANDRA SANDERS LCSW 1972971752
CHARLENE TURNER LCSW 1861862393
DR. RASHA KAMIL PORTIS LCSW 1336705177
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.