Lisa Blake Therapy LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

LISA BLAKE THERAPY LLC

Practice address

549 25TH St Ste 100
Ogden, UT 84401-2491

Phone

(801) 695-5057

NPI assigned

Dec 19, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Lisa Blake, LCSWNPI 1376177584

Title

Owner

Phone

(801) 695-5057

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lisa Jolene Blake

  • Clinical Social Worker
  • Riverdale, UT
  • NPI 1376177584
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1671408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754524800000",
    "number": "1063124451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1314 24TH ST",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844012902",
            "telephone_number": "801-695-5057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "549 25TH ST STE 100",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844012491",
            "telephone_number": "801-695-5057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LISA BLAKE THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-19",
        "last_updated": "2025-08-07",
        "certification_date": "2025-08-07",
        "status": "A",
        "authorized_official_last_name": "BLAKE",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-695-5057",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Lisajoleneblake@outlook.com",
            "affiliation": "N",
            "address_1": "4933 S 1500 W Ste 200",
            "city": "Riverdale",
            "state": "UT",
            "country_code": "US",
            "postal_code": "844057738",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kyle Lindley
• Justin Douglas Lindner, OTR/L, MOT, CHT
• Keith W. Linford, OD
• Taylor Woodward Linton, OD
• Phillip M Lintzenich, PA
• Margit Szabo Lister, M.D.
• Jordan Little
• Shanae Simmons Littlewood, RN
• Lloyd V. Tilt, DDS,Ms,PC
• Jacqueline Stuart Lloyd

• Clinical Social Worker in Ogden, UT
• Providers in Ogden, UT by specialty
• Clinical Social Worker in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.