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JACQUELINE BLAKE LCSW
NPI 1902282684
Social Worker - Clinical in Fairfax, VA

Active since August 05, 2015PECOS Enrolled
8221 WILLOW OAKS CORPORATE DR, 2-217E.01, FAIRFAX, VA 22031(703) 207-6976(703) 653-7008 Get Directions Write a Review

NPPES record last updated: August 5, 2015. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Jacqueline Blake Lcsw NPPES

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

JACQUELINE BLAKE LCSW (NPI 1902282684) is an individual clinical provider in Fairfax, Virginia, licensed in Virginia (0904009033) and active in the NPI registry since August 2015. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1902282684
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameJACQUELINE BLAKECredential: LCSW
Location Address8221 WILLOW OAKS CORPORATE DR, 2-217E.01Fairfax, VA 22031-4512
Mailing Address8221 Willow Oaks Corporate Dr, 2-217e.01Fairfax, VA 22031-4512 · (703) 207-6976 · Fax (703) 653-7008
Phone(703) 207-6976
Fax(703) 653-7008
Sole ProprietorYes
Enumeration DateAugust 5, 2015
✔ NPI 1902282684 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 VA · 0904009033
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.
8221 WILLOW OAKS CORPORATE DR, Fairfax, VA 22031
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jacqueline Blake Lcsw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignment

Medicare enrollment records show Jacqueline Blake reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Arlington County Government Department Of Managment & Finance
7.6 mi
Emergency Medical Services
1020 N HUDSON ST FL 3
Arlington, VA 22201
  • Reassigned Medicare billing, District of Columbia enrollment
  • 76 clinicians in this Medicare group
NPI 1073104832 (703) 228-7011

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 22031 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 $65.18 – $194.86
Typical copayment $0.00 (range $16.29 – $48.71)
Most-billed visit code NA
Established Patient
$80.66 typical visit price
range $21.40 – $158.88
Typical copayment $20.16 (range $5.35 – $39.72)
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 20

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

CONNIE LEE MD
Psychiatry & Neurology (Psychiatry)
8221 WILLOW OAKS CORPORATE DR
FAIRFAX, VA 22031
Fairfax County (703) 559-3000
NEIGHBORHOOD HEALTH
Clinic/Center (Federally Qualified Health Center (FQHC))
8221 WILLOW OAKS CORPORATE DR
FAIRFAX, VA 22031
Fairfax County (703) 535-5568
FELICIA ABOAGYE LNP
Nurse Practitioner (Psychiatric/Mental Health)
8221 WILLOW OAKS CORPORATE DR
FAIRFAX, VA 22031
Fairfax County (703) 559-3000
TRISHA MARIE HINDY BURKS LCSW
Social Worker (Clinical)
8221 WILLOW OAKS CORPORATE DR
FAIRFAX, VA 22031
Fairfax County (703) 559-3000
ZACHARY DALE LANDAU LCSW
Social Worker (Clinical)
8221 WILLOW OAKS CORPORATE DR
FAIRFAX, VA 22031
Fairfax County (703) 559-3000
GENOA HEALTHCARE LLC
Pharmacy (Long Term Care Pharmacy)
8221 WILLOW OAKS CORPORATE DR
FAIRFAX, VA 22031
Fairfax County (703) 852-0041
ANNA LEE KOOZMIN MSW, LCSW, LICSW
Social Worker (Clinical)
8221 WILLOW OAKS CORPORATE DR
FAIRFAX, VA 22031
Fairfax County (703) 324-7100
JULIA LYNN CONVERSE LCSW
Social Worker (Clinical)
8221 WILLOW OAKS CORPORATE DR
FAIRFAX, VA 22031
Fairfax County (703) 559-3000

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 Jacqueline Blake's NPI number?

The NPI number for Jacqueline Blake is 1902282684. It was assigned to this individual provider in the NPPES registry on August 5, 2015.

Where is Jacqueline Blake located?

Jacqueline Blake practices at 8221 Willow Oaks Corporate Dr 2-217e.01, Fairfax, VA 22031. The listed phone number is (703) 207-6976.

What is Jacqueline Blake's specialty?

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

Is Jacqueline Blake enrolled in Medicare?

Yes. Jacqueline Blake is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Jacqueline Blake's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jacqueline Blake reassigns Medicare benefits to Arlington County Government Department Of Managment & Finance (Arlington, VA). The 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 Jacqueline Blake's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Jacqueline Blake was last updated on August 5, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.