JEFFREY BLAKE (NPI# 1003827239) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003827239 |
| Entity Type | Individual |
| Full Name | JEFFREY BLAKE |
| Credential | LCSW |
| Practice Address |
22 Monument Square #403 Portland ME 04101-3914 |
| Mailing Address |
22 Monument Sq #403 Portland ME 04101-4082 |
| Practice Telephone | 2077499075 |
| Mailing Telephone | 2077499075 |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2013-03-11 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
LC9874 | ME | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ME | 325620099 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407834781 | Jeffrey Lee Blake | Physical Therapist | 1714 17th St, Santa Monica, CA 90404-4410 | 2006-01-06 |
| 1477545127 | Jeffrey M Blake | Obstetrics & Gynecology | 141 W 22nd St Ste 309, Anderson, IN 46016-4389 | 2005-08-18 |
| 1639616295 | Jeffrey Blake | Behavior Technician | 474 W 200 N, St George, UT 84770-4505 | 2017-01-20 |
| 1164431185 | Jeffrey W Blake | Internal Medicine | 1620 Nectarine St, Fernandina Beach, FL 32034-4724 | 2006-08-07 |
| 1093734451 | Jeffrey Blake | Pediatrics | 317 Martin Luther King Jr Way, Tacoma, WA 98405-4234 | 2006-07-18 |
| 1992792980 | Jeffrey D. Blake | Obstetrics & Gynecology | 250 Green St, Gardner, MA 01440-1396 | 2005-10-04 |
| Street Address |
22 MONUMENT SQUARE #403 |
| City | PORTLAND |
| State | ME |
| Zip Code | 04101-3914 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245871110 | Passport Health Holdings, LLC | Preventive Medicine | 22 Monument Square, Suite 507, Portland, ME 04101-4031 | 2019-10-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306450655 | Jocylin Egan | Nurse Practitioner | 442 Congress Street, 2nd Floor, Portland, ME 04101 | 2020-09-03 |
| 1255963559 | Portcity Home Healthcare LLC | In Home Supportive Care | 525 Forest Avenue, Suite 8, Portland, ME 04101 | 2020-02-05 |
| 1578101929 | Mohamed Hassan Mohamed | Student in an Organized Health Care Education/Training Program | 75 Lancaster St Ste 218a, Portland, ME 04101 | 2019-12-17 |
| 1841855301 | Portland Opioid Health Home | Counselor | 48 Free St., Mezzanine Level, Portland, ME 04101 | 2019-05-09 |
| 1093379224 | Alexandra Strawbridge Maurer | Acupuncturist | 50 A Cove Street, Portland, ME 04101 | 2019-04-23 |
| 1245719541 | Scott J Whited | Nurse Practitioner | 216 Vaughan St., Mcgeachy Hall, Portland, ME 04101 | 2018-08-08 |
| 1144733064 | Alixandria Elaine Marie Winchell | Massage Therapist | One City Center, Portland, ME 04101 | 2017-11-14 |
| 1417473638 | Rachel S Schwaner | Occupational Therapist | 78 Danforth Street, Apartment 6, Portland, ME 04101 | 2017-08-18 |
| 1023538154 | Derina Boothroyd | Audiologist-Hearing Aid Fitter | 985 Forest Ave., Portland, ME 04101 | 2017-06-20 |
| 1881123297 | Mark Mccullough | Social Worker | 57 Exchange Street, Suite 403, Portland, ME 04101 | 2017-06-08 |
| Find all providers in zip 04101 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| 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, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063012649 | Kathleen Russell | Social Worker | 7700 Sw Garden Home Rd Apt 23, Portland, OR 97223-7496 | 2020-10-31 |
| 1275131534 | Alice Hacker | Social Worker | 14702 Se Rhone St, Portland, OR 97236-2557 | 2020-10-09 |
| 1598372070 | Kristin Elizabeth Hajny | Social Worker | 9343 Sw Camille Ter, Portland, OR 97223-7042 | 2020-09-28 |
| 1821605759 | Melanie Smith | Social Worker | 4210 N Juneau St, Portland, OR 97203-2063 | 2020-09-24 |
| 1871100867 | Purely Spirit Holistic Health, LLC | Social Worker | 226 Stevens Ave Apt 9, Portland, ME 04102-2263 | 2020-09-24 |
| 1023624780 | Flourish Counseling and Consulting LLC | Social Worker | 8401 Ne Halsey St Ste 107, Portland, OR 97220-5670 | 2020-09-18 |
| 1245845130 | Crescent Psychotherapy | Social Worker | 168 Neal St, Portland, ME 04102-3343 | 2020-09-09 |
| 1861007676 | Yvonne Recchia | Social Worker | 5257 Ne Mlk, Portland, OR 97211-3282 | 2020-09-09 |
| 1447864327 | Gordon Keepers | Social Worker | 3181 Sw Sam Jackson Park Rd # Uhs8-l, Portland, OR 97239-3098 | 2020-09-08 |
| 1609484187 | Julie Pratt | Social Worker | 14 Culver Ln, Portland, CT 06480-1323 | 2020-07-21 |
| Find all providers in PORTLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.