NPI 1003827239

Jeffrey Blake, LCSW

Practitioner Clinical Social Worker Portland, ME

Practice location

Address: 22 Monument Square #403, Portland, ME 04101-3914
Phone: (207) 749-9075
Mailing address: 22 Monument Sq #403, Portland, ME 04101-4082

Registered specialties

Clinical Social Worker Primary

Behavioral Health & Social Service Providers Taxonomy 1041C0700X Licence LC9874 (ME)

Other Social Worker providers in Maine →

Registry record

NPI: 1003827239
Entity type: Individual
Sex (as registered): Male
NPI issued: 11 Aug 2006
Record last updated: 11 Mar 2013

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.