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LISA JOLENE BLAKE
NPI 1376177584
Social Worker - Clinical in Riverdale, UT

Active since February 26, 2020PECOS EnrolledAccepts Medicare Assignment
4933 S 1500 W STE 200, RIVERDALE, UT 84405(385) 427-1072 Get Directions Write a Review

NPPES record last updated: March 5, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Mar 5, 2023, Feb 26, 2020 (2 updates tracked since 2020).

About Lisa Jolene Blake NPPES

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

LISA JOLENE BLAKE (NPI 1376177584) is an individual clinical provider in Riverdale, Utah, licensed in Utah (6306212-3501) and active in the NPI registry since February 2020. She is enrolled in Medicare PECOS and is a graduate of Other (2020).

NPPES Registry Identity

NPI1376177584
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameLISA JOLENE BLAKE
Location Address4933 S 1500 W STE 200Riverdale, UT 84405-7738
Mailing Address1314 24th StOgden, UT 84401-2902 · (801) 695-5057
Phone(385) 427-1072
Sole ProprietorYes
Medical School CMSOtherGraduated 2020
Enumeration DateFebruary 26, 2020
Last NPPES UpdateMarch 5, 20232 updates tracked since enumeration
NPPES CertifiedMarch 5, 2023
✔ NPI 1376177584 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in UT · 6306212-3501
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.
4933 S 1500 W STE 200, Riverdale, UT 84405
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Accepted Insurance

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

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Lisa Jolene Blake is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8820592033
PECOS Enrollment IDI20250919003034
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 84405 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $54.34 – $166.03
Typical copayment $0.00 (range $13.58 – $41.50)
Most-billed visit code NA
Established Patient
$68.01 typical visit price
range $17.23 – $135.20
Typical copayment $17.00 (range $4.30 – $33.80)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 18

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MADELINE SMITH LCSW
Social Worker (Clinical)
4933 S 1500 W STE 200
RIVERDALE, UT 84405
Weber County (435) 237-1061
INSIGHTFUL COUNSELING SERVICES LLC
Counselor (Mental Health)
4933 S 1500 W STE 200
RIVERDALE, UT 84405
Weber County (801) 603-1544
WHISKER WILLOW, LLC
Counselor (Mental Health)
4933 S 1500 W STE 200
RIVERDALE, UT 84405
Weber County (801) 525-4645
CARING CONNECTIONS
Clinic/Center (Mental Health (Including Community Mental Health Center))
4933 S 1500 W STE 200
OGDEN, UT 84405
Weber County (801) 671-5622
MR. ZACKARY BUTTERFIELD CMHC, MED, EDS, BCN
Counselor (Mental Health)
4933 S 1500 W STE 200
RIVERDALE, UT 84405
Weber County (385) 330-2818
KIMBERLY MILLER LCSW
Social Worker (Clinical)
4933 S 1500 W STE 200
RIVERDALE, UT 84405
Weber County (801) 525-4645
KELLY ENSIGN EHLERS CMHC
Counselor (Mental Health)
4933 S 1500 W STE 200
RIVERDALE, UT 84405
Weber County (801) 603-1544
KIMBERLY PACE
Counselor (Mental Health)
4933 S 1500 W STE 200
RIVERDALE, UT 84405
Weber County (801) 698-9881

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's NPI number?

The NPI number for Lisa Blake is 1376177584. It was assigned to this individual provider in the NPPES registry on February 26, 2020.

Where is Lisa Blake located?

Lisa Blake practices at 4933 S 1500 W Ste 200, Riverdale, UT 84405. The listed phone number is (385) 427-1072.

What is Lisa Blake's specialty?

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

Is Lisa Blake enrolled in Medicare?

Yes. Lisa Blake is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Lisa Blake accept?

Health plans from BridgeSpan Health Company, Regence BlueCross BlueShield of Utah and Select Health list Lisa Blake 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 was last updated on March 5, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.