Marla M Blake, BSW, MA, LSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

AP02943399 Issued in WV

Practice address

2000 Eoff St
Suite 704
Wheeling, WV 26003-3823

Phone

(304) 234-8596

NPI assigned

Dec 6, 2010

Last updated

Dec 6, 2010By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Marla M Serafine Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

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.

• Park Valley Behavioral Health Care, PLLC

  • Psychiatry Physician
  • Wheeling, WV
  • NPI 1457357261
  NPD (past)

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

{
    "created_epoch": "1291593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291593600000",
    "number": "1609179100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 EOFF ST",
            "address_2": "SUITE 704",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "260033823",
            "telephone_number": "304-234-8596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 EOFF ST",
            "address_2": "SUITE 704",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "260033823",
            "telephone_number": "304-234-8596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "MARLA",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "BSW, MA, LSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-12-06",
        "last_updated": "2010-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WV",
            "license": "AP02943399",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0115328000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARLA",
            "last_name": "SERAFINE",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Matthew Black, RPH
• Amanda Jean Blackwell
• Aimee Renee Mae Blagovich, D.O.
• Felicia Ann Blake
• Jackie Blake
• Stacy Blake, MSCCC-SLP
• Trina Blakely
• Kathy Blatt, PT, DPT
• Leiandra Maria Bledsoe
• Bethany Blewitt

• Social Worker in Wheeling, WV
• Providers in Wheeling, WV by specialty
• Social Worker in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2010; 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.