Jonathan Kirkland Blauvelt, MA, LCADC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

37LC00306900 Issued in NJ

Practice address

2139 Hwy 35 Ste 120
Holmdel, NJ 07733-1094

Phone

(855) 698-3554

NPI assigned

Feb 24, 2014

Sex

Male

Sole proprietor

Yes

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

• Harbor Wellness & Recovery Center

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Holmdel, NJ
  • NPI 1184289548
  NPD (past)
• Sunrise Detox Cherry Hill LLC

  • Mental Illness Community Based Residential Treatment Facility
  • Cherry Hill, NJ
  • NPI 1295110179
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 21, 2022.

{
    "created_epoch": "1393200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655769600000",
    "number": "1679998918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1417 BRACE RD STE C",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080343524",
            "telephone_number": "856-795-0036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2139 HWY 35 STE 120",
            "city": "HOLMDEL",
            "state": "NJ",
            "postal_code": "077331094",
            "telephone_number": "855-698-3554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAUVELT",
        "first_name": "JONATHAN",
        "middle_name": "KIRKLAND",
        "name_prefix": "Mr.",
        "credential": "MA, LCADC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-02-24",
        "last_updated": "2022-06-21",
        "certification_date": "2022-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NJ",
            "license": "37LC00306900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Blozen Chiropractic PC
• Robert A. Blozen Jr., D.C.
• Jogle Ann Bacnis Borja, RN
• John Brady, CADC
• Ryan William Brennessel, D.O.

• All providers in Holmdel, NJ
• Addiction (Substance Use Disorder) Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 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.