Jason Josef Blake in Loves Park - Clinical
Jason Josef Blake - NPI 1780730101
Jason Josef Blake is a Clinical in Loves Park, Illinois. Jason Josef Blake practices all healthcare services and medical treatments related to Clinical. The NPI Number for Jason Josef Blake is 1780730101. The last update date is 2007-07-08.
Jason Josef Blake's current location address is 7124 Windsor Lake Pkwy, Loves Park, Illinois. You can contact this provider via phone number 8159883142. The mailing address for Jason Josef Blake is 7124 Windsor Lake Pkwy, Loves Park, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jason Josef Blake |
|---|---|
| Address | 7124 Windsor Lake Pkwy, Loves Park, Illinois |
| Phone Number | 8159883142 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | LCSW |
NPI Number Detail
| NPI Number | 1780730101 |
|---|---|
| Provider Enumeration Date | 2007-01-26 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 7124 Windsor Lake Pkwy |
|---|---|
| City | Loves Park |
| State | Illinois (IL) |
| Post Code | 611113800 |
| Phone Number | 8159883142 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
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Definition: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certif |
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What is the unique identifier code issued to Jason Josef Blake by the Centers for Medicare & Medicaid Services (CMS)?
The Jason Josef Blake has been assigned the NPI (National Provider Identifier) 1780730101. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Where is the Jason Josef Blake located?
The Jason Josef Blake is located at 7124 Windsor Lake Pkwy, Loves Park, IL 611113800.
What is the Jason Josef Blake's specialty and taxonomy code?
The Jason Josef Blake's specialty is Clinical, and the corresponding taxonomy code is 1041C0700X.
When did the Jason Josef Blake receive its 1780730101?
The Jason Josef Blake was issued its 1780730101 on 2007-01-26, which is the date when the organization was assigned this unique identifier.
When was the information related to Jason Josef Blake most recently updated or refreshed?
The details pertaining to the Jason Josef Blake, including its address, specialty, and other relevant information, were last updated or refreshed on 2007-07-08.