NPI
Justin Laron Blake
NPI 1932821956
Read from the NPPES registry on October 23, 2026.
Facts
- Status
- Active
- Credential
- LCSW
- Type
- Individual
- Enumeration date
- 2022-09-15
- Last updated
- 2022-09-15
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Specialties
Licenses
- License GA
- CSW007974
- License FL
- SW17317
Location
- Practice location
- 2393 Boulder Chase Dr
- City
- Ellenwood GA
- Postal code
- 30294-1687
- Phone
- (305) 972-7007
Medicare
- PECOS
- No PECOS enrollment row matched this NPI.
LEIE
No exclusion found for this NPI in the OIG LEIE file dated October 9, 2026. Confirm on OIG's online search.
Nearby
Other NPIs in Ellenwood, GA. 401 records in the public file.
Public data from NPPES and CMS. Not a credentialing determination.
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