Cassidy Blake
Individual provider Active NPI Occupational Therapist · Forestville, MD
NPI 1144925660 · NPPES record last updated Apr 10, 2023
Key facts
- NPI
- 1144925660
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- 09959 (MD)
- Practice address
- 7500 Marlboro Pike
Forestville, MD 20747-4306 - Phone
- (301) 238-4723
- NPI assigned
- Apr 3, 2023
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT210002188 | DC | MD | Occupational Therapist |
| 09959 | MD | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| LKM Therapy Center | Occupational Therapist | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT210002188 | DC | |
| Occupational Therapist | 225X00000X | 09959 | MD | Yes |
Addresses
Primary practice location
7500 Marlboro Pike
Forestville, MD 20747-4306
Mailing address
7500 Marlboro Pike
Forestville, MD 20747-4306
Other providers in Forestville, MD
- Meikel Barnes
- Basics Counseling Services LLC
- Basics Group Practice LLC
- Basics Group Practice, LLC
- Nichole Blackmon
- Neh Bouesela
- Tarisa Brinson
- Candace Brown
- Calvin St.George Chambers
- Changing Attitudes Counseling Services
All providers in Forestville, MD · Occupational Therapist in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 10, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.