Individual provider Active NPI

Peter Lee, LSW

  • Clinical Social Worker
  • Eatontown, NJ
National Provider Identifier
1619613528
Registry record updated Jun 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SL06701300 Issued in NJ
Practice address
615 Hope Rd Ste 3B
Eatontown, NJ 07724-1273
Phone
(732) 724-1234
NPI assigned
May 12, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 104100000X 44SL06701300 NJ
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 44SL06701300 NJ Primary

Addresses

Primary practice location

615 Hope Rd Ste 3B
Eatontown, NJ 07724-1273

Mailing address

615 Hope Rd Ste 3B
Eatontown, NJ 07724-1273
Phone (732) 724-1234

Other practice location 1

111 New Jersey 35
cliffwood, NJ 07721
Phone (732) 812-5489 ext. 231

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

LicenseStateTypeSpecialty
44SL06701300NJMDSocial Worker

Interoperability endpoints

  • Direct secure messaging: positivereset.peterlee@153760.advancedmd-direct.com

NPI Registry JSON

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

{
    "created_epoch": "1652313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654300800000",
    "number": "1619613528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 HOPE RD STE 3B",
            "city": "EATONTOWN",
            "state": "NJ",
            "postal_code": "077241273",
            "telephone_number": "732-724-1234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 HOPE RD STE 3B",
            "city": "EATONTOWN",
            "state": "NJ",
            "postal_code": "077241273",
            "telephone_number": "732-724-1234"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 New Jersey 35",
            "address_purpose": "LOCATION",
            "city": "cliffwood",
            "state": "NJ",
            "postal_code": "07721",
            "country_code": "US",
            "telephone_number": "732-812-5489 x231",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "PETER",
        "credential": "LSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-05-12",
        "last_updated": "2022-06-04",
        "certification_date": "2022-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker",
            "state": "NJ",
            "license": "44SL06701300",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SL06701300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eatontown, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2022; 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.