Individual provider Active NPI

Edward Bloch, LSCSW

  • Clinical Social Worker
  • Lawrence, KS
National Provider Identifier
1619957040
Registry record updated Apr 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS 2132 Issued in KS
Practice address
2619 W 6TH St
Suite a
Lawrence, KS 66049-4304
Phone
(785) 842-2752
Fax
(785) 842-2750
NPI assigned
Jan 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCS 2132 KS Primary

Addresses

Primary practice location

2619 W 6TH St
Suite a
Lawrence, KS 66049-4304

Mailing address

2619 W 6TH St
Suite a
Lawrence, KS 66049-4304
Phone (785) 218-3965

Other identifiers 2

IdentifierTypeStateIssuer
069666OtherKSBLUE CROSS BLUE SHIELD KS
200655550AMedicaidKS

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS 2132KSMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1137715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303948800000",
    "number": "1619957040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2619 W 6TH ST",
            "address_2": "SUITE A",
            "city": "LAWRENCE",
            "state": "KS",
            "postal_code": "660494304",
            "telephone_number": "785-218-3965",
            "fax_number": "785-842-2750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2619 W 6TH ST",
            "address_2": "SUITE A",
            "city": "LAWRENCE",
            "state": "KS",
            "postal_code": "660494304",
            "telephone_number": "785-842-2752",
            "fax_number": "785-842-2750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOCH",
        "first_name": "EDWARD",
        "credential": "LSCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-20",
        "last_updated": "2011-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KS",
            "license": "LCS 2132",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD KS",
            "identifier": "069666",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200655550A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrence, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2011; 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.