Laura Benson Blake, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

114534 Issued in MA

Practice address

200 Springs Rd
Bedford, MA 01730-1198

Phone

(781) 687-2612

NPI assigned

Jul 17, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1247788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653955200000",
    "number": "1689804197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 HURD ST",
            "city": "FITCHBURG",
            "state": "MA",
            "postal_code": "014204920",
            "telephone_number": "978-235-4936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 SPRINGS RD",
            "city": "BEDFORD",
            "state": "MA",
            "postal_code": "017301198",
            "telephone_number": "781-687-2612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "LAURA",
        "middle_name": "BENSON",
        "name_prefix": "Mrs.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-17",
        "last_updated": "2022-05-31",
        "certification_date": "2022-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "114534",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "13632",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bionic Skins LLC
• George J Bistany, MSW, LICSW
• Douglas Blake Bitman, PH.D.
• Ella Bitman, LICSW
• Carol Bittenson
• Charles Blanchard Jr., LPN
• Emily Jamison Bliss
• Lisa D. Bloom-Charette, PH.D.
• Lawrence Joel Bobrin, M.D.
• Body of Work, Inc.

• Clinical Social Worker in Bedford, MA
• Providers in Bedford, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2022; 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.