Active NPI
Allan Jerome Blau, LICSW
- Mental Health Counselor
- Mountainside, NJ
National Provider Identifier
1902384191
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 107977
- Practice address
- 1101 Bristol Rd
Mountainside, NJ 07092-2311 - Phone
- (908) 543-0220
- NPI assigned
- Jul 31, 2018
- Last updated
- Jul 31, 2018
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 107977 | MA | Primary |
Addresses
Primary practice location
1101 Bristol Rd
Mountainside, NJ 07092-2311
Mailing address
1451 Orchard Rd
Mountainside, NJ 07092-1710
Phone (908) 531-1340
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 107911 | Other | MA | COMMONWEALTH OF MASSACHUSETTS DIVISION OF PROFESSIONAL LICENSURE |
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 |
|---|---|---|---|
| 107977 | MA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1532995200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1532995200000",
"number": "1902384191",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1451 ORCHARD RD",
"city": "MOUNTAINSIDE",
"state": "NJ",
"postal_code": "070921710",
"telephone_number": "908-531-1340"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1101 BRISTOL RD",
"city": "MOUNTAINSIDE",
"state": "NJ",
"postal_code": "070922311",
"telephone_number": "908-543-0220"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLAU",
"first_name": "ALLAN",
"middle_name": "JEROME",
"name_prefix": "Dr.",
"credential": "LICSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-07-31",
"last_updated": "2018-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MA",
"license": "107977",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COMMONWEALTH OF MASSACHUSETTS DIVISION OF PROFESSIONAL LICENSURE",
"identifier": "107911",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mountainside, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.