Individual provider Active NPI

Blake Stuckey

  • School Social Worker
  • Cleveland, OH
National Provider Identifier
1295335800
Registry record updated Nov 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Social WorkerTaxonomy code 1041S0200X
License
S.2005262 Issued in OH
Practice address
1750 Ansel Rd Apt 511
Cleveland, OH 44106-4103
Phone
(717) 495-6961
NPI assigned
Nov 1, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Social Worker 1041S0200X S.2005262 OH Primary

Addresses

Primary practice location

1750 Ansel Rd Apt 511
Cleveland, OH 44106-4103

Mailing address

1750 Ansel Rd Apt 511
Cleveland, OH 44106-4103
Phone (717) 495-6961

Other practice location 1

12 Dove Ct
Dillsburg, PA 17019-8509
Phone (717) 495-6961

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

LicenseStateTypeSpecialty
S.2005262OHMDSchool Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1604188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604188800000",
    "number": "1295335800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1750 ANSEL RD APT 511",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441064103",
            "telephone_number": "717-495-6961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 ANSEL RD APT 511",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441064103",
            "telephone_number": "717-495-6961"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12 Dove Ct",
            "address_purpose": "LOCATION",
            "city": "Dillsburg",
            "state": "PA",
            "postal_code": "170198509",
            "country_code": "US",
            "telephone_number": "717-495-6961",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STUCKEY",
        "first_name": "BLAKE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-01",
        "last_updated": "2020-11-01",
        "certification_date": "2020-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "OH",
            "license": "S.2005262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2020; 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.