Jesse L Blake, MSW, LISW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I.2405108 Issued in OH

Practice address

2000 Noble Dr
Wooster, OH 44691-5353

Phone

(330) 264-3232

NPI assigned

Oct 22, 2018

Last updated

Aug 7, 2024By 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 3

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Southeast, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Columbus, OH
  • NPI 1932169497
  Medicare reassignment NPD
• Southeast, Inc

  • Federally Qualified Health Center (FQHC)
  • Mount Gilead, OH
  • NPI 1114893203
  NPD
• Village Network

  dba The Village Network

  • Voluntary or Charitable Agency
  • Wooster, OH
  • NPI 1124057914
  NPD (past)

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

{
    "created_epoch": "1540166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722988800000",
    "number": "1407322092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 NOBLE DR",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446915353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 NOBLE DR",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446915353",
            "telephone_number": "330-264-3232"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "40060 National Rd",
            "address_purpose": "LOCATION",
            "city": "Bethesda",
            "state": "OH",
            "postal_code": "437199763",
            "country_code": "US",
            "telephone_number": "740-792-0082",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "53 14th St",
            "address_purpose": "LOCATION",
            "city": "Wheeling",
            "state": "WV",
            "postal_code": "260033433",
            "country_code": "US",
            "telephone_number": "304-905-6516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "JESSE",
        "middle_name": "L",
        "credential": "MSW, LISW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-22",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.2405108",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.1800525-TRNE",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.2005362",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katelyn Blackwell, LPC
• Kathryn Elizabeth Blair
• Kimberley Blair, CNP
• Ashley Dawn Blake
• Erin Louise Blake, LSW
• James R Blamble
• Megan Blasczak, LPCC
• Taylor Nicole Blaydes, RDN, LD
• Selali Blege
• Zhanee Blevins

• Clinical Social Worker in Wooster, OH
• Providers in Wooster, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.