Blue Lake Services PC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

BLUE LAKE SERVICES PC

Practice address

1858 Attaya Rd
Lakewood, NJ 08701-2901

Phone

(718) 534-0689

NPI assigned

May 9, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Meyer Seeve

Title

Owner

Phone

(718) 534-0689

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1462752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462752000000",
    "number": "1104272269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1858 ATTAYA RD",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087012901",
            "telephone_number": "718-534-0689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1858 ATTAYA RD",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087012901",
            "telephone_number": "718-534-0689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE LAKE SERVICES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-09",
        "last_updated": "2016-05-09",
        "status": "A",
        "authorized_official_last_name": "SEEVE",
        "authorized_official_first_name": "MEYER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-534-0689"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Lakewood, NJ
• Providers in Lakewood, NJ by specialty
• Clinical Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.