Amanda Blake, LICSW, MSSW
NPI 1174773469 · Clinical Social Worker · Grand Forks, ND
Enrolled with Medicare as Practitioner - Clinical Social Worker · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Amanda Blake, LICSW, MSSW is a Clinical Social Worker provider in Grand Forks, ND (NPI 1174773469).
Provider details
- NPI number
- 1174773469
- Entity type
- Individual
- Primary specialty
- Clinical Social WorkerBehavioral Health & Social Service Providers
- Credential
- LICSW, MSSW
- Sex
- Female
- Sole proprietor
- No
- License
- 4753 (ND)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Behavioral Health & Social Service Providers
Behavioral Health & Social Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
17 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Additional practice locations (1)
- 412 Demers AveGrand Forks, ND 58201-4508Phone: (701) 787-7728
Registry dates
- Enumerated
- 2008-09-24
- Last updated
- 2022-10-31
- Certified
- 2022-10-31
Frequently asked questions
- What is Amanda Blake's NPI number?
- Amanda Blake's National Provider Identifier (NPI) is 1174773469, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Amanda Blake's specialty?
- Amanda Blake is listed in the NPPES registry with a primary specialty of Clinical Social Worker (Behavioral Health & Social Service Providers).
- Where is Amanda Blake located?
- Amanda Blake's practice location on file with NPPES is 2808 17th Ave S, Grand Forks, ND 58201-4010.
- What is Amanda Blake's phone number?
- The practice phone number listed in the NPPES registry for Amanda Blake is (701) 738-8363.
- Does Amanda Blake accept Medicare?
- Amanda Blake is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Amanda Blake's NPI active?
- Yes — Amanda Blake's NPI (1174773469) is active in the NPPES registry as of the last update on 2022-10-31.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.