Individual provider Active NPI

Lisa Freidenrich

  • Clinical Social Worker
  • Westfield, NJ
National Provider Identifier
1093363210
Registry record updated Nov 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC06284000 Issued in NJ
Practice address
1051 Wychwood Rd
Westfield, NJ 07090-2356
Phone
(908) 507-8391
NPI assigned
Aug 30, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 44SC06284000 NJ Primary
Counselor 101Y00000X
Clinical Social Worker 1041C0700X 44SC06284000
Health Information Technician 247000000X
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1051 Wychwood Rd
Westfield, NJ 07090-2356

Mailing address

1051 Wychwood Rd
Westfield, NJ 07090-2356
Phone (908) 507-8391

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
I20240126002538 NJ Practitioner - Clinical Social Worker 0941653836 Practice locations: Montclair, NJ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

49 Park St
Unit 100
Montclair, NJ 07042-3439
Phone (908) 507-8391

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44SC06284000NJMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Lisa Freidenrich Clinical CurrentSince Dec 1, 2023 Accepting new patients

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": "1567123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700352000000",
    "number": "1093363210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1051 WYCHWOOD RD",
            "city": "WESTFIELD",
            "state": "NJ",
            "postal_code": "070902356",
            "telephone_number": "908-507-8391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1051 WYCHWOOD RD",
            "city": "WESTFIELD",
            "state": "NJ",
            "postal_code": "070902356",
            "telephone_number": "908-507-8391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREIDENRICH",
        "first_name": "LISA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-30",
        "last_updated": "2023-11-19",
        "certification_date": "2023-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC06284000",
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": "44SC06284000",
            "primary": false
        },
        {
            "code": "247000000X",
            "taxonomy_group": "",
            "desc": "Technician, Health Information",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westfield, NJ

Sources for this page

Verify at the official NPI Registry.