Blake, Justin Laron
Blake, Justin Laron is an sole proprietor health care provider with primary practice located at 2393 Boulder Chase Dr , Ellenwood GA 30294-1687. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Blake, Justin Laron can be contacted via phone (305) 972-7007.Contact Information
Primary practice address
2393 Boulder Chase Dr
Ellenwood GA 30294-1687
Phone: (305) 972-7007
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | CSW007974 | Georgia |
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | SW17317 | Florida |
Profile Details
| NPI number | 1932821956 |
|---|---|
| LBN Legal business name | Blake, Justin Laron |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 15th, 2022 |
| Last updated | Sep 15th, 2022 - about 4 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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