Healthcare Provider Details

I. General information

NPI: 1184532699
Provider Name (Legal Business Name): ASIHA BLAKE LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

627 RACE ST
CAMBRIDGE MD
21613-2333
US

IV. Provider business mailing address

804 S DIVISION ST
SALISBURY MD
21804-6431
US

V. Phone/Fax

Practice location:
  • Phone: 410-228-3223
  • Fax:
Mailing address:
  • Phone: 443-614-6378
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number33906
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: