Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jacqueline Blake, LCSW

Individual provider Clinical Social Worker · NPI 1902282684

Jacqueline Blake, LCSW is a Clinical Social Worker in Fairfax, Virginia. Practices as a sole proprietor. Licensed in Virginia.

Licensed in
VA
In the registry since
2015
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

8221 Willow Oaks Corporate Dr 2-217E.01
Fairfax, VA 22031-4512
Phone: (703) 207-6976
Fax: (703) 653-7008
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 0904009033 (VA)

Record details

NPI number1902282684
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorYes
NPI enumeratedAugust 5, 2015
Last updated in NPPESAugust 5, 2015
Mailing address8221 Willow Oaks Corporate Dr, 2-217e.01, Fairfax, VA 22031-4512

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