Individual
BLAKE BERNLOHR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW, LAC
Contact information
Practice address
111 VESTA RD, SALIDA, CO 81201-9327
(719) 539-6502
Mailing address
111 VESTA RD, SALIDA, CO 81201-9327
(719) 539-6502
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
171M00000X
Case Manager/Care Coordinator
ACD.0001780
CO
Other
Enumeration date
05/11/2021
Last updated
04/25/2022
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