AMY M BLAKE (NPI# 1164407367) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164407367 |
| Entity Type | Individual |
| Full Name | AMY M BLAKE |
| Other Name | AMY M DIECKMAN |
| Credential | MSW |
| Practice Address |
1905 Stadium Blvd Jefferson City MO 65109-1961 |
| Mailing Address |
11 Brentwil Blvd Linn Creek MO 65052-2237 |
| Practice Telephone | 5736343000 |
| Practice Fax Number | 5736344010 |
| Enumeration Date | 2005-12-09 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 104100000X | Social Worker | 2003012111 | MO | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821200270 | Amy Michelle Blake | Specialist/Technologist | 37770 State Route 124, Pomeroy, OH 45769-9302 | 2007-05-05 |
| 1386148708 | Amy Blake | Dermatology | 410 Market St Ste 400, Chapel Hill, NC 27516-4061 | 2018-03-20 |
| 1003315615 | Amy Jo Blake | Behavior Technician | 1200 Sterrett Rd, Fairfield, VA 24435-2629 | 2018-02-09 |
| 1336528751 | Amy Blake | Dentist | 2976 Summit St Ste 201, Oakland, CA 94609-3405 | 2015-05-19 |
| 1063838464 | Amy Blake | Nurse Practitioner | 340 Webb Smith Dr, Colfax, LA 71417-1910 | 2014-03-10 |
| 1871737668 | Amy C Blake | Pediatrics | 759 Chestnut Street, W2810, Springfield, MA 01107-1619 | 2009-04-24 |
| 1427273234 | Amy Blake | Speech-Language Pathologist | 350 South Main Street, Suite 315 Invo Healthcare Associates, Doylestown, PA 18901 | 2007-04-16 |
| 1437293099 | Amy Blake | Social Worker | 98 North Ave, Suite 30, Skowhegan, ME 04976-1942 | 2007-02-16 |
| 1013978535 | Amy Susan Blake | Nurse Practitioner | 680 Blair Mill Rd, Horsham, PA 19044-2223 | 2006-04-01 |
| Street Address |
1905 STADIUM BLVD |
| City | JEFFERSON CITY |
| State | MO |
| Zip Code | 65109-1961 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093329229 | Jordan Hargrove | Social Worker | 1905 Stadium Blvd, Jefferson City, MO 65109-1961 | 2020-09-04 |
| 1073156998 | Michele Ernst Christman | Counselor | 1905 Stadium Blvd, Jefferson City, MO 65109-1961 | 2019-10-23 |
| 1033752209 | Chloe Payton Rimer | Counselor | 1905 Stadium Blvd, Jefferson City, MO 65109-1961 | 2019-10-21 |
| 1922570639 | Heather Renee Klemp | Social Worker | 1905 Stadium Blvd, Jefferson City, MO 65109-1961 | 2018-12-19 |
| 1780163436 | Marissa Rae Abbott | Counselor | 1905 Stadium Blvd, Jefferson City, MO 65109-1961 | 2018-08-13 |
| 1326526542 | Amber Dawn Johnson | Social Worker | 1905 Stadium Blvd, Jefferson City, MO 65109-1961 | 2018-07-31 |
| 1295213619 | Titus Shane Mayberry | Counselor | 1905 Stadium Blvd, Jefferson City, MO 65109 | 2018-07-30 |
| 1417433731 | Danielle Mackenzie Howell | Social Worker | 1905 Stadium Blvd, Jefferson City, MO 65109-1961 | 2018-07-19 |
| 1063905305 | Katelyn Mccoy | Social Worker | 1905 Stadium Blvd, Jefferson City, MO 65109-1961 | 2018-06-12 |
| 1942793765 | Nancy J Chamberlain | Social Worker | 1905 Stadium Blvd, Jefferson City, MO 65109 | 2018-06-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518449321 | Kara D Roderick | Physical Therapist | 1115 Fairgrounds Road, Jefferson City, MO 65109 | 2018-08-29 |
| 1851871214 | Integrative Medicine, LLC | Internal Medicine | 999 Diamond Rdg Ste 201, Jefferson City, MO 65109 | 2018-08-15 |
| 1972020394 | Rehab Care Group East, LLC | Clinic/Center | Primrose Retirement Community Jefferson City, 1214 Freedom Boulevard, Jefferson City, MO 65109 | 2017-08-25 |
| 1124558986 | Nicholas Rehagen | Specialist/Technologist | 304 Timber Creek Rd, Jefferson City, MO 65109 | 2017-06-14 |
| 1982004214 | Kara Elizabeth Wilbers | Occupational Therapist | 1105 Fairgrounds Rd, Jefferson City, MO 65109 | 2014-08-22 |
| 1942510334 | Loftin Eyecare, LLC | Optometrist | 724 West Stadium Boulevard, # 029 Walmart Vision Center, Jefferson City, MO 65109 | 2010-10-19 |
| 1306077250 | Paula Hancock Johnson | Social Worker | 1303 Edgewood Dr Ste 5, Jefferson City, MO 65109 | 2009-07-27 |
| 1679701296 | Capital Region Medical Center | Family Medicine | 3308 W Edgewood, Suite B, Jefferson City, MO 65109 | 2009-06-23 |
| 1972730141 | Nancy S Stork | Counselor | 204 Metro, Suite B, Jefferson City, MO 65109 | 2009-06-16 |
| 1356522916 | Walk Easy LLC | Durable Medical Equipment & Medical Supplies | 4810 Rainbow Dr., Jefferson City, MO 65109 | 2007-11-23 |
| Find all providers in zip 65109 | ||||
| Taxonomy Code | 104100000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public. |
| Notes: Source: National Association of Social Workers, 2009 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922352012 | Spring Grove Counseling | Social Worker | 211 A Oscar Drive, Jefferson City, MO 65101-5167 | 2012-10-29 |
| 1306077250 | Paula Hancock Johnson | Social Worker | 1303 Edgewood Dr Ste 5, Jefferson City, MO 65109 | 2009-07-27 |
| 1578621009 | Deborah M Middleton | Social Worker | 3405 W. Truman, 101, Jefferson City, MO 65109-5861 | 2006-12-05 |
| 1457456790 | Nancy K Ellis-ordway | Social Worker | 1022a Northeast Dr, Jefferson City, MO 65109 | 2006-09-13 |
| 1326072695 | Lawrence Joseph Ulm Sr. | Social Worker | 398 Dix Rd, Suite 101, Jefferson City, MO 65109-1407 | 2006-07-10 |
| 1063462091 | Barbara Jean Douglass | Social Worker | 3016 Dupont Cir, Jefferson City, MO 65109-6188 | 2006-05-11 |
| 1740266345 | Patricia A Alewel | Social Worker | 1303 Edgewood Dr, Suite 3a, Jefferson City, MO 65109-1943 | 2005-12-16 |
| 1093329229 | Jordan Hargrove | Social Worker | 1905 Stadium Blvd, Jefferson City, MO 65109-1961 | 2020-09-04 |
| 1487294203 | Leanna April Fowlds | Social Worker | 227 Metro Dr, Jefferson City, MO 65109-1134 | 2020-01-09 |
| 1922570639 | Heather Renee Klemp | Social Worker | 1905 Stadium Blvd, Jefferson City, MO 65109-1961 | 2018-12-19 |
| Find all providers in JEFFERSON CITY | ||||
| City | JEFFERSON CITY |
| Zip Code | 65109 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.