Adam Gary Blake, LCSW
Individual provider Active NPI Clinical Social Worker · Lawrenceville, NJ
NPI 1609437227 · NPPES record last updated Jun 25, 2019
Key facts
- NPI
- 1609437227
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 44SC05869800 (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
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- 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 Therapy
Practice addresses (Care Compare)
9 Charred Oak LN
East Windsor, NJ 08520-1803
Phone (848) 666-0264
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230803004048 | NJ | Practitioner - Clinical Social Worker | 6406217694 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 44SC05869800 | NJ | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Better Be Blake Therapy | Clinical | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 44SC05869800 | NJ | Yes |
Addresses
Primary practice location
4 Princess Rd Ste 206
Lawrenceville, NJ 08648-2322
Mailing address
4 Princess Rd Ste 206
Lawrenceville, NJ 08648-2322
Phone (609) 482-3701
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 44SC05869800 | Other | NJ | LICENSED CLINICAL SOCIAL WORKER |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | adam@lifebacknj.com | Health Information Exchange (HIE) |
Other providers in Lawrenceville, NJ
- Bio-Medical Applications of New Jersey, Inc.
- Colleen Birkhofer
- Sara Rose Biscoe
- Bruce David Bitcover
- Brittany Blair
- Camille Ann Bloomberg
- Paul Kofi Boahene
- Rikki Ellyn Bobchin
- Stacy Bodine
- Joanne Elizabeth Booth
All providers in Lawrenceville, NJ · Clinical Social Worker in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 25, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.