Larry Blake, LCSW

NPI 1720239726 · on the registry since 2008 · sole proprietor

Practice

Address: 75 Harrison Ave
First Floor
Jersey City, NJ 07304
Phone: (201) 451-5425
Fax: (201) 451-7499
Organisation at this address: Mystepro
Cag Memorial Health Center
Khaleidoscope Health Care Inc.
Inferred from a shared address, not stated in the registry.

Registry record

Primary taxonomy: 1041C0700X
1041C0700X
Licence states on file: NJ
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2008-10-08

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in New Jersey