BLAKE WALLACE CSWA
NPI 1518702976
Social Worker - Clinical in Portland, OR
NPI Status: Active since June 27, 2024
Contact Information
3500 NE MARTIN LUTHER KING JR BLVD STE 200
PORTLAND, OR
ZIP 97212
Phone: (503) 327-8205
- Individual
- Male
- Social Worker
- Clinical
About BLAKE WALLACE
This page provides the complete NPI Profile along with additional information for Blake Wallace, a provider established in Portland, Oregon with a medical specialization in Social Worker, focusing in clinical . The healthcare provider is registered in the NPI registry with number 1518702976 assigned on June 2024. The practitioner's primary taxonomy code is 1041C0700X with license number A15334 (OR). The provider is registered as an individual and his NPI record was last updated one year ago.
- NPI
- 1518702976
- Provider Name
- BLAKE WALLACE CSWA
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 3500 NE MARTIN LUTHER KING JR BLVD STE 200 PORTLAND, OR 97212
- Location Phone
- (503) 327-8205
- Mailing Address
- 3500 NE MARTIN LUTHER KING JR BLVD STE 200 PORTLAND, OR 97212
- Mailing Phone
- (503) 327-8205
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 06-27-2024
- Last Update Date
- 07-19-2024
- Code Navigator
A clinical social worker like Blake Wallace is licensed to diagnose and treat mental, behavioral, and emotional disorders. A clinical social worker helps patients develop strategies to change behavior or cope with difficult situations and refer patients to other resources or services, such as support groups or other mental health professionals.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Social Worker Clinical
- Taxonomy Code
- 1041C0700X
- Type
- Behavioral Health & Social Service Providers
- License No.
- A15334
- License State
- OR
- Taxonomy Description
- 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.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 1041C0700X | Behavioral Health & Social Service Providers | Social Worker | 24-QMHP-R-2920 (OR) |
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 5 | 1 | 8 | 7 | 0 | 2 | 9 | 7 | 6 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 5 | 2 | 8 | 14 | 0 | 4 | 9 | 14 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 5 + 2 + 8 + 1 + 4 + 0 + 4 + 9 + 1 + 4 + 24 = 64 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 64 = 6 | 6 | ||||||||
The NPI number 1518702976 is valid because the calculated check digit 6 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 7 providers are registered at the same or nearby location.
KRISTEN FERNANDEZ-KONG PMHNP-BC
Nurse Practitioner
(Psychiatric/Mental Health)
3500 NE MARTIN LUTHER KING JR BLVD STE 200
PORTLAND, OR
ZIP 97212
DIANA MARIN DURAN
Social Worker
3500 NE MARTIN LUTHER KING JR BLVD STE 200
PORTLAND, OR
ZIP 97212
ANYA GABRIELLE CREA VANCE LPC-C7301
Counselor
(Professional)
3500 NE MARTIN LUTHER KING JR BLVD STE 200
PORTLAND, OR
ZIP 97212
ERIC NARAMORE MFT ASSOCIATE
Marriage & Family Therapist
3500 NE MARTIN LUTHER KING JR BLVD STE 200
PORTLAND, OR
ZIP 97212
JILLIAN WALSH LPCA
Counselor
(Professional)
3500 NE MARTIN LUTHER KING JR BLVD STE 200
PORTLAND, OR
ZIP 97212
MARY CHAKHTOURA
Counselor
(Mental Health)
3500 NE MARTIN LUTHER KING JR BLVD STE 200
PORTLAND, OR
ZIP 97212
EMILY COLLEN VAUGHAN LPC
Counselor
(Professional)
3500 NE MARTIN LUTHER KING JR BLVD STE 200
PORTLAND, OR
ZIP 97212
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1518702976, enumerated as an "individual" on June 27, 2024.
The provider is located at 3500 NE MARTIN LUTHER KING JR BLVD STE 200 PORTLAND, OR 97212 and the phone number is (503) 327-8205.
Social Worker with taxonomy code 1041C0700X and a focus in Clinical.
