Lora Lynn Blake, LMSW
Individual provider Active NPI Clinical Social Worker · Macomb, MI
NPI 1992685945 · NPPES record last updated Sep 2, 2025
Key facts
- NPI
- 1992685945
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 6801104538 (MI)
- Practice address
- 50578 Nesting Ridge Dr
Macomb, MI 48044-1383 - Phone
- (586) 292-1359
- NPI assigned
- Sep 2, 2025
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6801104538 | MI | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6801104538 | MI | Yes |
Addresses
Primary practice location
50578 Nesting Ridge Dr
Macomb, MI 48044-1383
Mailing address
50578 Nesting Ridge Dr
Macomb, MI 48044-1383
Phone (586) 292-1359
Other providers in Macomb, MI
- Cristina Enza Billiau
- Kevin Binsell
- Bio-Medical Applications of Michigan, Inc.
- Glenda Bjornson
- Earl Black
- Caroa Blazejewski
- Jay Gerald Blazius
- Bloch Drugs Co Inc
- Sergei G Boikov
- Giuseppina Bommartio
All providers in Macomb, MI · Clinical Social Worker in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 2, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.