Adam Gary Blake, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SC05869800 Issued in NJ

Practice address

4 Princess Rd Ste 206
Lawrenceville, NJ 08648-2322

Phone

(609) 482-3701

Fax

(609) 482-3702

NPI assigned

Jun 25, 2019

Last updated

Jun 25, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Better Be Blake TherapyGroup PAC ID 1951741339, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Interoperability endpoints

• Direct secure messaging: adam@lifebacknj.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Better Be Blake Therapy

  • Clinical Social Worker
  • East Windsor, NJ
  • NPI 1487345955
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1561420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561420800000",
    "number": "1609437227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 PRINCESS RD STE 206",
            "city": "LAWRENCEVILLE",
            "state": "NJ",
            "postal_code": "086482322",
            "telephone_number": "609-482-3701",
            "fax_number": "609-482-3702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 PRINCESS RD STE 206",
            "city": "LAWRENCEVILLE",
            "state": "NJ",
            "postal_code": "086482322",
            "telephone_number": "609-482-3701",
            "fax_number": "609-482-3702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "ADAM",
        "middle_name": "GARY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-25",
        "last_updated": "2019-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05869800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "adam@lifebacknj.com",
            "affiliation": "N",
            "endpointDescription": "e-mail",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "secure e-mail address",
            "address_1": "4 Princess Rd Ste 206",
            "city": "Lawrenceville",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "086482322",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Bio-Medical Applications of New Jersey, Inc. (Fresenius Kidney Care Harney's Corner)
• Colleen Birkhofer, APN
• Sara Rose Biscoe, PT, DPT
• Bruce David Bitcover, DPM
• Brittany Blair, LCSW
• Camille Ann Bloomberg, LPC, LCADC
• Paul Kofi Boahene
• Rikki Ellyn Bobchin, LCSW
• Stacy Bodine
• Joanne Elizabeth Booth, PH.D.

• Clinical Social Worker in Lawrenceville, NJ
• Providers in Lawrenceville, 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 Jun 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.