Melissa Blake, ACSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

ASW 31925 Issued in CA

Practice address

2825 Santa Monica Blvd
Suite 100
Santa Monica, CA 90404-2429

Phone

(310) 566-1470

NPI assigned

Jan 7, 2013

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

Other identifiers 1

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": "1357516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357516800000",
    "number": "1548507882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2825 SANTA MONICA BLVD",
            "address_2": "SUITE 100",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042429",
            "telephone_number": "310-566-1470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2825 SANTA MONICA BLVD",
            "address_2": "SUITE 100",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042429",
            "telephone_number": "310-566-1470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "MELISSA",
        "credential": "ACSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-07",
        "last_updated": "2013-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "ASW 31925",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "ASW 31925",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "ASW 31925",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF BEHAVIORAL SCIENCES",
            "identifier": "ASW 31925",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Diane Black, L.AC.
• Richard Blackburn
• Janine A Blackman, M.D.
• Blake Physical Therapy, PC
• Jeffrey Lee Blake, PT
• Karen L Blanchard, M.D.
• Alejandra Blanco
• Roseanne Sofia Evangelista Blanco, OTR/L
• Hanna Lorraine Blankemeier, MD
• Cassandra Blaylock, NP

• Clinical Social Worker in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2013; 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.