Blake, Jason Josef

Blake, Jason Josef is an sole proprietor health care provider with primary practice located at 7124 Windsor Lake Pkwy Suite # 10, Loves Park IL 61111-3800. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Blake, Jason Josef can be contacted via phone (815) 988-3142.

Contact Information

Primary practice address
7124 Windsor Lake Pkwy Suite # 10 Loves Park IL 61111-3800
Phone: (815) 988-3142
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X Illinois

Profile Details

NPI number 1780730101
LBN Legal business name Blake, Jason Josef
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 26th, 2007
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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