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LISA BLAKE THERAPY LLC
NPI 1063124451
Social Worker - Clinical in Ogden, UT

Active since December 19, 2022
549 25TH ST STE 100, OGDEN, UT 84401(801) 695-5057 Get Directions Write a Review

NPPES record last updated: August 7, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Aug 7, 2025, Dec 19, 2022 (2 updates tracked since 2022).

About Lisa Blake Therapy Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LISA BLAKE THERAPY LLC (NPI 1063124451) is a healthcare organization registered as a clinical in Ogden, Utah and active in the NPI registry since December 2022. The organization lists Lisa Blake, Owner, as its authorized official.

NPPES Registry Identity

NPI1063124451
Entity TypeOrganization
Primary Taxonomy1041C0700X
Legal Business NameLISA BLAKE THERAPY LLC
Location Address549 25TH ST STE 100Ogden, UT 84401-2491
Mailing Address1314 24th StOgden, UT 84401-2902 · (801) 695-5057
Phone(801) 695-5057
Organization SubpartNo
Authorized OfficialLisa BlakeOwner · (801) 695-5057
Enumeration DateDecember 19, 2022
Last NPPES UpdateAugust 7, 20252 updates tracked since enumeration
NPPES CertifiedAugust 7, 2025
✔ NPI 1063124451 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
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, 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.
549 25TH ST STE 100, Ogden, UT 84401
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Regence BlueCross BlueShield of Utah.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Lisa Blake Therapy Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Lisa Blake Therapy LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Lisa Blake
Clinical Social Worker
NPI 1376177584
4933 S 1500 W STE 200
Riverdale, UT 84405
(385) 427-1072
✔ PECOS✔ Accepts Medicare5.3 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lisa Blake Therapy LLC's NPI number?

The NPI number for Lisa Blake Therapy LLC is 1063124451. It was assigned to this organization in the NPPES registry on December 19, 2022.

Where is Lisa Blake Therapy LLC located?

Lisa Blake Therapy LLC is located at 549 25th St Ste 100, Ogden, UT 84401. The listed phone number is (801) 695-5057.

What is Lisa Blake Therapy LLC's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Lisa Blake Therapy LLC enrolled in Medicare?

Yes. Lisa Blake Therapy LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Lisa Blake Therapy LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Social Worker) reassigns their Medicare billing to Lisa Blake Therapy LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Lisa Blake Therapy LLC accept?

Health plans from BridgeSpan Health Company and Regence BlueCross BlueShield of Utah list Lisa Blake Therapy LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Lisa Blake Therapy LLC was last updated on August 7, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.