Provider Demographics
NPI:1528440906
Name:BLAKE, LINDSEY CHRISTINE (MSW, MHP, LSWAIC)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:CHRISTINE
Last Name:BLAKE
Suffix:
Gender:F
Credentials:MSW, MHP, LSWAIC
Other - Prefix:
Other - First Name:LINDSEY
Other - Middle Name:CHRISTINE
Other - Last Name:KEHOE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4526 FEDERAL AVE
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98203-2132
Mailing Address - Country:US
Mailing Address - Phone:425-349-6200
Mailing Address - Fax:
Practice Address - Street 1:4526 FEDERAL AVE
Practice Address - Street 2:BLDG 1
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98203-2132
Practice Address - Country:US
Practice Address - Phone:425-349-6200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-23
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASC61105749104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker