Individual provider · Type 1 NPI

Katie Blake, LCSW

Clinical Social Worker · Santa Rosa, CA

NPI number 1104375393 Active

Practice location

2225 Challenger Way
Santa Rosa, CA 95407-5441

Mailing address

1275 4th St # 4011
Santa Rosa, CA 95404-4057

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700X93792 (CA)

Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…

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About NPI 1104375393

Katie Blake, LCSW's National Provider Identifier is 1104375393, issued on Sep 28, 2016. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Santa Rosa, CA. The record was last updated on Apr 13, 2023.