Jill K Blake, LMSW-CC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

MC13621 Issued in ME

Practice address

50 Moody St
Saco, ME 04072-1536

Phone

(800) 434-3000

NPI assigned

Aug 3, 2012

Last updated

Feb 20, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jill K Santamore Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1343952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392854400000",
    "number": "1235485699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 MOODY ST",
            "city": "SACO",
            "state": "ME",
            "postal_code": "040721536",
            "telephone_number": "800-434-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 MOODY ST",
            "city": "SACO",
            "state": "ME",
            "postal_code": "040721536",
            "telephone_number": "800-434-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "JILL",
        "middle_name": "K",
        "credential": "LMSW-CC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-03",
        "last_updated": "2014-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "MC13621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JILL",
            "last_name": "SANTAMORE",
            "middle_name": "K",
            "credential": "LMSW-CC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Casey Bisson, MS OTR/L
• Elizabeth M Black, LMSW-CC
• Janice A Black, MSW
• Nancy Blair, OT ASSISTANT
• Michelle A Blais, LMT
• Ann E. Blanchard, LCSW
• Eva R Blethen, LCSW
• Michael Gary Boardman, LMSW-CC
• Elizabeth S. Bodor, LCPC
• Mary Therese Bohon, LCSW

• Clinical Social Worker in Saco, ME
• Providers in Saco, ME by specialty
• Clinical Social Worker in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.