Active NPI
Blake Lauren Hickman, ASW
- Social Worker
- Eureka, CA
National Provider Identifier
1770211641
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 117308
- Practice address
- 720 Wood Street
Eureka, CA 95501 - Phone
- (707) 572-8566
- NPI assigned
- Aug 9, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 117308 | CA | Primary |
Addresses
Primary practice location
720 Wood Street
Eureka, CA 95501
Mailing address
4525 Valley West Blvd
Arcata, CA 95521
Phone (225) 270-1333
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 117308 | CA | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1660003200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695168000000",
"number": "1770211641",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4525 VALLEY WEST BLVD",
"city": "ARCATA",
"state": "CA",
"postal_code": "95521",
"telephone_number": "225-270-1333"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "720 WOOD STREET",
"city": "EUREKA",
"state": "CA",
"postal_code": "95501",
"telephone_number": "707-572-8566"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HICKMAN",
"first_name": "BLAKE",
"middle_name": "LAUREN",
"credential": "ASW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-08-09",
"last_updated": "2023-09-20",
"certification_date": "2023-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "CA",
"license": "117308",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eureka, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.