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JUSTIN LARON BLAKE LCSW
NPI 1932821956
Social Worker - Clinical in Ellenwood, GA

Active since September 15, 2022
2393 BOULDER CHASE DR, ELLENWOOD, GA 30294(305) 972-7007 Get Directions Write a Review

NPPES record last updated: September 15, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Justin Laron Blake Lcsw NPPES

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

JUSTIN LARON BLAKE LCSW (NPI 1932821956) is an individual clinical provider in Ellenwood, Georgia, licensed in Florida (SW17317) and active in the NPI registry since September 2022.

NPPES Registry Identity

NPI1932821956
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameJUSTIN LARON BLAKECredential: LCSW
Location Address2393 BOULDER CHASE DREllenwood, GA 30294-1687
Mailing Address2393 Boulder Chase DrEllenwood, GA 30294-1687 · (305) 972-7007
Phone(305) 972-7007
Sole ProprietorYes
Enumeration DateSeptember 15, 2022
NPPES CertifiedSeptember 15, 2022
✔ NPI 1932821956 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
Licenses✔ Licensed in FL · SW17317✔ Licensed in GA · CSW007974
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.
2393 BOULDER CHASE DR, Ellenwood, GA 30294
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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 Justin Blake's NPI number?

The NPI number for Justin Blake is 1932821956. It was assigned to this individual provider in the NPPES registry on September 15, 2022.

Where is Justin Blake located?

Justin Blake practices at 2393 Boulder Chase Dr, Ellenwood, GA 30294. The listed phone number is (305) 972-7007.

What is Justin Blake's specialty?

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

When was this NPI record last updated?

The NPPES record for Justin Blake was last updated on September 15, 2022. 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.