Individual
ALEX BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1625 SCHRADER BLVD, LOS ANGELES, CA 90028-6213
(323) 993-7500
Mailing address
1625 SCHRADER BLVD, LOS ANGELES, CA 90028-6213
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
135612
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01536011
MEDICAL
CA
Enumeration date
09/20/2021
Last updated
02/13/2026
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