Active NPI
Peter Lee, LSW
- Clinical Social Worker
- Eatontown, NJ
National Provider Identifier
1619613528
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 44SL06701300
- 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
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 | 44SL06701300 | NJ | |
| Clinical Social Worker | 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
| License | State | Type | Specialty |
|---|---|---|---|
| 44SL06701300 | NJ | MD | Social Worker |
Interoperability endpoints
- 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.