Laurene Marie Blake, LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

06441 Issued in MD

Practice address

6665 Security Blvd
Woodlawn, MD 21207-4018

Phone

(410) 265-7291

Fax

(410) 265-7294

NPI assigned

Feb 8, 2016

Last updated

Dec 9, 2021By 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

• Laurene M Walker Professional name

Medicare fee-for-service enrollment

Enrolled in MD

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1977

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bon Ridge Wellness LLCGroup PAC ID 1951775337, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bon Ridge Wellness, LLC

  • Clinical Social Worker
  • Windsor Mill, MD
  • NPI 1922710995
  Medicare reassignment Care Compare group NPD
• MSBC Five Star Program Inc

  dba The Renaissance Center

  • Professional Counselor
  • Woodlawn, MD
  • NPI 1427256379
  NPD (past)

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

{
    "created_epoch": "1454889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639008000000",
    "number": "1265890065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6665 SECURITY BLVD",
            "city": "WOODLAWN",
            "state": "MD",
            "postal_code": "212074018",
            "telephone_number": "410-265-7291",
            "fax_number": "410-265-7294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6665 SECURITY BLVD",
            "city": "WOODLAWN",
            "state": "MD",
            "postal_code": "212074018",
            "telephone_number": "410-265-7291",
            "fax_number": "410-265-7294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "LAURENE",
        "middle_name": "MARIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-08",
        "last_updated": "2021-12-09",
        "certification_date": "2021-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MD",
            "license": "06441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURENE",
            "last_name": "WALKER",
            "middle_name": "M",
            "credential": "LCSWC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Beautiful Hearts and Minds Health Services
• Beautiful Hearts and Minds Health Services
• Beautiful Hearts and Minds Health Services, LLC (Beautiful Hearts and Minds Wellness Center)
• John Robert Belcher, PH.D., LCSWC
• Odejah Berry, LMSW
• Bluepeak Diagnostic LLC
• Sarah Bolling, LGSW
• Nichole Boswell
• Bridgepoint Recovery & Wellness
• Cynthia Denise Broadnax, MSN, CRNP

• Social Worker in Woodlawn, MD
• Providers in Woodlawn, MD by specialty
• Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.