Active NPI
Pamela Blake, MSW
- Social Worker
- Palm Springs, FL
National Provider Identifier
1134473473
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- ISW 6007
- Practice address
- 2112 S Congress Ave
Suite 104
Palm Springs, FL 33406-7670 - Phone
- (561) 653-6292
- NPI assigned
- Nov 8, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | ISW 6007 | FL | Primary |
Addresses
Primary practice location
2112 S Congress Ave
Suite 104
Palm Springs, FL 33406-7670
Mailing address
2112 S Congress Ave
Suite 104
Palm Springs, FL 33406-7670
Phone (561) 653-6292
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ISW 6007 | FL | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Multicultural Community Mental Health Center Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- Palm Springs, FL
- NPI 1003087537
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1352332800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1352332800000",
"number": "1134473473",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2112 S CONGRESS AVE",
"address_2": "SUITE 104",
"city": "PALM SPRINGS",
"state": "FL",
"postal_code": "334067670",
"telephone_number": "561-653-6292"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2112 S CONGRESS AVE",
"address_2": "SUITE 104",
"city": "PALM SPRINGS",
"state": "FL",
"postal_code": "334067670",
"telephone_number": "561-653-6292"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLAKE",
"first_name": "PAMELA",
"credential": "MSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-11-08",
"last_updated": "2012-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "FL",
"license": "ISW 6007",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palm Springs, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.