Organization
LISA BLAKE THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA BLAKE LCSW (OWNER)
(801) 695-5057
Entity
Organization
Contact information
Practice address
549 25TH ST STE 100, OGDEN, UT 84401-2491
(801) 695-5057
Mailing address
1314 24TH ST, OGDEN, UT 84401-2902
(801) 695-5057
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
12/19/2022
Last updated
08/07/2025
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