MRS. JESSICA BLAKE (LISW) – Clinical Social Worker, NPI 1013142991

MRS. JESSICA BLAKE (LISW) is a healthcare provider. based in Cedar rapids, Iowa. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LISW. They hold a License No. 06700 (IA). The NPI Number for MRS. JESSICA BLAKE (LISW) is 1013142991

Main info

Female
Sole Proprietor
20 Years Of Experience
Accepts Medicare Assignment
Name
MRS. JESSICA BLAKE (LISW)
NPI
1013142991
Phone
(319) 396-1066
Address
3100 E AVE NW
Enumeration Date
21 May 2009
Last Update Date
21 May 2009

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3193961066
Graduation Year
2006 (20 years ago)
PAC ID
6709930175
Group Practice PAC ID
0446140222
Professional Enrollment ID
I20090819000595
Address ID
IA522332310HI1510XRDXX300
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience48
Completeness75
Years active:17State licenses:1Digital endpointsOther names

827 CLINICAL SOCIAL WORKER in IA

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Provider Addresses for MRS. JESSICA BLAKE (LISW)

  • 3100, E Avenue Northwest, Cedar Rapids, Linn County, Iowa, 52405, United States

    SUITE 101

    CEDAR RAPIDS, IA 524052962

    Phone: (319) 396-1066

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2009-08-19

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20090819000595IClinical Social WorkerIATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
90834Psychotherapy, 45 minutes18318$0
View full utilization report →

Insurance plans in this area (ZIP 52405)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0446140222View full group profile
NameSpecialtyState
Nurse PractitionerIA
P S Y C H I A T R YIA
Mental Health CounselorIA
Clinical Social WorkerIA
Nurse PractitionerIA
-IA
Clinical Social WorkerIA
Clinical Social WorkerIA
P S Y C H I A T R YCT
P S Y C H I A T R YIA

Reviews

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Frequently asked questions

What is the registry number for MRS. JESSICA BLAKE (LISW)?
The registry entry for MRS. JESSICA BLAKE (LISW) shows NPI 1013142991.
Should I treat MRS. JESSICA BLAKE (LISW) as an active provider?
Patients and plans typically see MRS. JESSICA BLAKE (LISW) as active in the national extract.
What type of care does MRS. JESSICA BLAKE (LISW) provide?
MRS. JESSICA BLAKE (LISW)'s profile centers on Clinical Social Worker. Clinical services aligned with this taxonomy classification.
Is MRS. JESSICA BLAKE (LISW) tied to Cedar Rapids, Iowa?
If you are local to Cedar Rapids, Iowa, MRS. JESSICA BLAKE (LISW) may be relevant to your search.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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