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Contact Information

LINDA S BLAKE, LICSW
19029 US HIGHWAY 19 NORTH, VILLA 22D
CLEARWATER, FL33764
 Phone: 508-369-0202
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

1041C0700X 80 Licensed Clinical Social Worker
Indicates primary specialty

NPI Profile & details for LINDA S BLAKE · (Female)

NPI Number 1215419791
Status Active
Credentials LICSW (Licensed Independent Clinical Social Worker)
Entity Individual
Enumeration date 08/31/2018
Last updated 08/31/2018 - About 8 years ago
Sole proprietor 1 Yes
Identifiers
  • MA License # 1030914
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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