Justin Laron Blake, LCSW
NPI 1932821956ActiveIndividual· Social Worker, Clinical· Ellenwood, GA
Social Worker, Clinical (LCSW) in Ellenwood, Georgia, licensed in FL and GA, with an NPI issued in September 2022.
Overview
| NPI | 1932821956 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | LCSW |
| Sole proprietor | Yes |
| NPI issued | Sep 15, 2022 |
| Last updated in NPPES | Sep 15, 2022 |
| Certified by provider | Sep 15, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Social Worker, Clinical Primary | 1041C0700X | SW17317 | FL |
| Social Worker, Clinical | 1041C0700X | CSW007974 | GA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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