Active NPI
Clinton A Bauer, LSW
- Social Worker
- Brick, NJ
National Provider Identifier
1457555195
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 44SL05537400
- Practice address
- 425 Jack Martin Blvd
Brick, NJ 08724-7732 - Phone
- (732) 840-3380
- NPI assigned
- Jun 14, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | X05825 | NM | |
| Social Worker | 104100000X | 44SL05537400 | NJ | Primary |
Addresses
Primary practice location
425 Jack Martin Blvd
Brick, NJ 08724-7732
Mailing address
425 Jack Martin Blvd
Brick, NJ 08724-7732
Phone (732) 840-3380
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 44SL05537400 | NJ | MD | Social Worker |
| X05825 | NM | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181779200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1247011200000",
"number": "1457555195",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "425 JACK MARTIN BLVD",
"city": "BRICK",
"state": "NJ",
"postal_code": "087247732",
"telephone_number": "732-840-3380"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "425 JACK MARTIN BLVD",
"city": "BRICK",
"state": "NJ",
"postal_code": "087247732",
"telephone_number": "732-840-3380"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAUER",
"first_name": "CLINTON",
"middle_name": "A",
"name_prefix": "Mr.",
"credential": "LSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-06-14",
"last_updated": "2009-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NM",
"license": "X05825",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NJ",
"license": "44SL05537400",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brick, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.