LAKEWOOD COMMUNITY SERVICES CORP.
Complete NPI Record 1093085649
Community/Behavioral Health in Lakewood, NJ
Active since January 12, 2012
Complete NPI Dataset
This page contains the complete raw NPPES record for Lakewood Community Services Corp. (NPI 1093085649), a community/behavioral health organization in Lakewood, NJ. All 32 fields on file are listed with their current values and official NPPES definitions, exactly as recorded in the National Plan and Provider Enumeration System. Only fields that contain data are included, so the number of fields shown varies from one NPI record to another.
Use the tools below to filter fields by category, search within the record, or jump straight to a specific field. You can download the full record as a CSV, JSON, Markdown or text file, or filter first and export only the fields you need. The Print Clean Summary button produces a printer-friendly copy of the record.
Registry File Document Utilities
- NPI: 1093085649 Field 1/32
- The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
- Entity Type Code: 2 Field 2/32
- Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
- Employer Identification Number EIN: Not available Field 3/32
- The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
- Provider Organization Name Legal Business Name: LAKEWOOD COMMUNITY SERVICES CORP. Field 4/32
- The name of the organization provider. If the provider is an organization, this is the legal business name.
- Provider First Line Business Mailing Address: 450 W KENNEDY BLVD Field 5/32
- The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
- Provider Business Mailing Address City Name: LAKEWOOD Field 6/32
- The city name in the mailing address of the provider being identified.
- Provider Business Mailing Address State Name: NJ Field 7/32
- The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
- Provider Business Mailing Address Postal Code: 087011269 Field 8/32
- The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
- Provider Business Mailing Address Country Code If outside U S : US Field 9/32
- The country code in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address country code".
- Provider First Line Business Practice Location Address: 225 4TH ST Field 10/32
- The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
- Provider Business Practice Location Address City Name: LAKEWOOD Field 11/32
- The city name in the location address of the provider being identified.
- Provider Business Practice Location Address State Name: NJ Field 12/32
- The State code in the location of the provider being identified.
- Provider Business Practice Location Address Postal Code: 087013228 Field 13/32
- The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
- Provider Business Practice Location Address Country Code If outside U S : US Field 14/32
- The country code in the location address of the provider being identified.
- Provider Business Practice Location Address Telephone Number: 7329016001 Field 15/32
- The telephone number associated with the location address of the provider being identified.
- Authorized Official Last Name: WEISBERG Field 18/32
- The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
- Authorized Official First Name: MOSHE Field 19/32
- The first name of the authorized official.
- Authorized Official Title or Position: PRESIDENT Field 20/32
- The title or position of the authorized official.
- Authorized Official Telephone Number: 7329016001 Field 21/32
- The 10-position telephone number of the authorized official.
- Healthcare Provider Taxonomy Code 1: 251B00000X Field 22/32
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Healthcare Provider Primary Taxonomy Switch 1: N Field 23/32
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Healthcare Provider Taxonomy Code 2: 251S00000X Field 24/32
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Provider License Number 2: 101920204 Field 25/32
- The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
- Provider License Number State Code 2: NJ Field 26/32
- The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
- Healthcare Provider Primary Taxonomy Switch 2: Y Field 27/32
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Other Provider Identifier 1: 0279579 Field 28/32
- An additional identifier number for the provider, either current or previously used. This may include IDs issued by health plans, state agencies, or other organizations. The value is collected from the NPI application or update form.
- Other Provider Identifier Type Code 1: 05 Field 29/32
- A code that specifies the type of additional identifier associated with the provider, either current or past. Examples include UPIN (Universal Provider Identification Number), NSC (National Supplier Clearinghouse), OSCAR (CMS Certification Number), DEA (Drug Enforcement Administration number), state Medicaid ID, or a plan-specific PIN. The value is collected from the NPI application or update form.
- Other Provider Identifier State 1: NJ Field 30/32
- The two-letter state code representing the U.S. state or territory that issued the additional provider identifier. This links the Other Provider Identifier to the state where it is valid or was assigned.
- Is Organization Subpart: N Field 31/32
- Indicates whether the provider is a subpart of a larger organization. This is a single-character code: "Y" means the entity is an organizational subpart, while "N" means it is not. Subparts typically include hospital departments, clinics, or other distinct units that fall under a parent organization.
Secondary Practice Locations 22
The first line of the secondary practice location address of the provider being identified. For providers with more than one physical location, this is a secondary practice location address. This address cannot include a Post Office box.
1500 Pine St
Location 1/22Lakewood, NJ 08701-4985 · Phone (732) 901-6001
613 Oak St
Location 2/22Lakewood, NJ 08701-5331 · Phone (732) 901-6001
285 River Ave
Location 3/22Lakewood, NJ 08701-4808 · Phone (732) 901-6001
140 Lehigh Ave
Location 4/22Lakewood, NJ 08701-4526 · Phone (732) 901-6001
388 Chestnut St
Location 5/22Lakewood, NJ 08701-5809 · Phone (732) 901-6001
1000 Cross St
Location 6/22Lakewood, NJ 08701-4061 · Phone (732) 901-6001
410 Oberlin Ave S
Location 7/22Lakewood, NJ 08701-6903 · Phone (732) 901-6001
500 Summer Ave
Location 8/22Lakewood, NJ 08701-4616 · Phone (732) 901-6001
200 Norwood Ave,, Ste. 5
Location 9/22Lakewood, NJ 08701 · Phone (732) 901-6001
100 Route 70
Location 10/22Lakewood, NJ 08701-7406 · Phone (732) 901-6001
1640 W County Line Rd
Location 11/22Lakewood, NJ 08701-1167 · Phone (732) 901-6001
301 Essex Ave
Location 12/22Lakewood, NJ 08701-5353 · Phone (732) 901-6001
66 Neiman Rd
Location 13/22Lakewood, NJ 08701-4026 · Phone (732) 901-6001
755 Somerset Ave
Location 14/22Lakewood, NJ 08701-2129 · Phone (732) 901-6001
725 Vassar Ave
Location 15/22Lakewood, NJ 08701-6908 · Phone (732) 901-6001
1400 Pine St
Location 16/22Lakewood, NJ 08701-4963 · Phone (732) 901-6001
360 Oak St
Location 17/22Lakewood, NJ 08701-5349 · Phone (732) 901-6001
299 Monmouth Ave
Location 18/22Lakewood, NJ 08701-3207 · Phone (732) 901-6001
500 W Kennedy Blvd
Location 19/22Lakewood, NJ 08701-1254 · Phone (732) 901-6001
525 Route 70
Location 20/22Lakewood, NJ 08701-5847 · Phone (732) 901-6001
415 Carey St
Location 21/22Lakewood, NJ 08701-1747 · Phone (329) 016-0017
488 Old Whitesville Rd
Location 22/22Lakewood, NJ 08701-3793 · Phone (732) 901-9001
Other Provider Identifiers 1
Legacy and payer-issued identifiers reported to the NPPES registry for this provider.
0279579 Medicaid
Identifier 1/1State: NJ
Medicaid (State-specific): A provider identification number assigned by an individual state's Medicaid program, used for billing and enrollment within that state's Medicaid system.
Medicaid (State-specific): A provider identification number assigned by an individual state's Medicaid program, used for billing and enrollment within that state's Medicaid system.
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