ANN BLAKE (LISW) – Clinical Social Worker, NPI 1093842551

ANN 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. 06535 (IA). The NPI Number for ANN BLAKE (LISW) is 1093842551

Main info

Female
21 Years Of Experience
Accepts Medicare Assignment
Name
ANN BLAKE (LISW)
NPI
1093842551
Phone
(319) 365-3993
Address
PO BOX 1408
Enumeration Date
28 February 2007
Last Update Date
6 January 2009

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3193653993
Graduation Year
2005 (21 years ago)
PAC ID
6204929409
Group Practice PAC ID
6204726342
Professional Enrollment ID
I20070904000559
Address ID
IA524025433CE1730XNEXX400
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

827 CLINICAL SOCIAL WORKER in IA

Provider Addresses for ANN BLAKE (LISW)

  • PO BOX 1408

    CEDAR RAPIDS, IA 524061408

    Phone: (319) 365-3993

    Fax: (319) 364-0116

    Type: Mailing

  • 1730 1ST AVE NE

    CEDAR RAPIDS, IA 524025433

    Phone: (319) 365-3993

    Fax: (319) 364-0116

    Type: Location

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: 2007-09-04

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
I20070904000559IClinical 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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 52406)

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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: 6204726342View full group profile
NameSpecialtyState
P S Y C H I A T R YIA
P S Y C H I A T R YIA
P S Y C H I A T R YIA
-IA
P S Y C H I A T R YIA
-IA
P S Y C H I A T R YIA
Clinical PsychologistIA
Clinical PsychologistIA
-IA

Reviews

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Frequently asked questions

What federal number belongs to ANN BLAKE (LISW)?
The federal identifier for ANN BLAKE (LISW) is NPI 1093842551.
Is ANN BLAKE (LISW)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Can you summarize ANN BLAKE (LISW)'s specialty in plain language?
Clinically, the directory lists ANN BLAKE (LISW) with Clinical Social Worker. Clinical services aligned with this taxonomy classification.
Does ANN BLAKE (LISW) practice in Iowa?
You will see Cedar Rapids, Iowa on file for ANN BLAKE (LISW) alongside any extra practice locations.
How can I contact ANN BLAKE (LISW)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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