Individual provider Active NPI

Virginia Blakeman, LCSW

  • Clinical Social Worker
  • Hillsborough, NJ
National Provider Identifier
1902200736
Registry record updated Nov 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC05744600 Issued in NJ
Practice address
2 Clerico LN Ste 103
Hillsborough, NJ 08844-1620
Phone
(843) 424-3465
NPI assigned
Oct 22, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 28, 2022

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 44SC05744600 NJ Primary

Addresses

Primary practice location

2 Clerico LN Ste 103
Hillsborough, NJ 08844-1620

Mailing address

PO Box 5705
Hillsborough, NJ 08844-5705
Phone (843) 424-3465

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171026000853 NJ Practitioner - Clinical Social Worker 3476829052 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2 Clerico LN
Suite 103
Hillsborough, NJ 08844-1620
Phone (843) 424-3465

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44SC05744600NJMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
V. Blakeman Psychotherapy LLC Clinical CurrentSince Jan 2, 2018 Accepting new patients

Locations

390 Amwell Rd
Ste 317
Hillsborough, NJ 08844
Phone (843) 424-3465

2 Clerico Ln
Ste 103
Hillsborough, NJ 08844
Phone (843) 424-3465

710 Easton Ave
Ste D
Somerset, NJ 08873
Phone (732) 309-4897

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1413936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669593600000",
    "number": "1902200736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5705",
            "city": "HILLSBOROUGH",
            "state": "NJ",
            "postal_code": "088445705",
            "telephone_number": "843-424-3465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 CLERICO LN STE 103",
            "city": "HILLSBOROUGH",
            "state": "NJ",
            "postal_code": "088441620",
            "telephone_number": "843-424-3465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKEMAN",
        "first_name": "VIRGINIA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-22",
        "last_updated": "2022-11-28",
        "certification_date": "2022-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05744600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hillsborough, NJ

Sources for this page

Verify at the official NPI Registry.