Blake Bernlohr, LCSW, LAC
Individual provider Active NPI Clinical Social Worker · Salida, CO
NPI 1366026742 · NPPES record last updated Apr 25, 2022
Key facts
- NPI
- 1366026742
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- Practice address
- 111 Vesta Rd
Salida, CO 81201-9327 - Phone
- (719) 539-6502
- NPI assigned
- May 11, 2021
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ACD.0001780 | CO | MD | Case Manager/Care Coordinator |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | |||
| Case Manager/Care Coordinator | 171M00000X | ACD.0001780 | CO | |
| Clinical Social Worker | 1041C0700X | Yes |
Addresses
Primary practice location
111 Vesta Rd
Salida, CO 81201-9327
Mailing address
111 Vesta Rd
Salida, CO 81201-9327
Phone (719) 539-6502
Other providers in Salida, CO
- Miranda Kate Beason
- Amy Caroline Leach Beauprez
- Donna Sheree Beddingfield
- David Matthew Belmont
- Teresa Ann Bernhard
- Hanna Kate Bingham
- Greg K. Bixby
- Marilyn Waugh Bouldin
- Caroline Brackmann
- Michelle Bridges
All providers in Salida, CO · Clinical Social Worker in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 25, 2022. 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.