Blake, Melissa

Blake, Melissa is an individual health care provider with primary practice located at 2825 Santa Monica Blvd Suite 100, Santa Monica CA 90404-2429. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Marriage & Family Therapist. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Blake, Melissa can be contacted via phone (310) 566-1470.

Contact Information

Primary practice address
2825 Santa Monica Blvd Suite 100 Santa Monica CA 90404-2429
Phone: (310) 566-1470
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X ASW 31925 California
Behavioral Health & Social Service Providers / Clinical 1041C0700X ASW 31925 California
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X ASW 31925 California

Profile Details

NPI number 1548507882
LBN Legal business name Blake, Melissa
Credentials ACSW
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 7th, 2013
Last updated Jan 7th, 2013 - about 13 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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Identifiers

StateTypeNumberIssuer
All States NPI 1548507882 NPPES
California Other ASW 31925 BOARD OF BEHAVIORAL SCIENCES

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