Provider Demographics
NPI:1356186019
Name:BLITZ, ALEX CHARLES (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:ALEX
Middle Name:CHARLES
Last Name:BLITZ
Suffix:
Gender:M
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:364 FARLEY AVE
Mailing Address - Street 2:
Mailing Address - City:SCOTCH PLAINS
Mailing Address - State:NJ
Mailing Address - Zip Code:07076-1108
Mailing Address - Country:US
Mailing Address - Phone:908-230-1175
Mailing Address - Fax:
Practice Address - Street 1:364 FARLEY AVE
Practice Address - Street 2:
Practice Address - City:SCOTCH PLAINS
Practice Address - State:NJ
Practice Address - Zip Code:07076-1108
Practice Address - Country:US
Practice Address - Phone:908-230-1175
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-26
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC063441001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical