Provider Demographics
NPI:1285252296
Name:BLANCK-SINGER, GAGE (LPC LCADC)
Entity type:Individual
Prefix:
First Name:GAGE
Middle Name:
Last Name:BLANCK-SINGER
Suffix:
Gender:M
Credentials:LPC LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:608 MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:KINNELON
Mailing Address - State:NJ
Mailing Address - Zip Code:07405-2129
Mailing Address - Country:US
Mailing Address - Phone:973-727-7901
Mailing Address - Fax:
Practice Address - Street 1:608 MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:KINNELON
Practice Address - State:NJ
Practice Address - Zip Code:07405-2129
Practice Address - Country:US
Practice Address - Phone:973-727-7901
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-07
Last Update Date:2023-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00319200101YA0400X
NJ37PC00923800101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health