Individual provider Active NPI

Lorraine Frances Jacobs, MSW, LCSW

  • Clinical Social Worker
  • Perth Amboy, NJ
National Provider Identifier
1093920050
Registry record updated Sep 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC05370200 Issued in NJ
Practice address
570 Lee St
Perth Amboy, NJ 08861-3053
Phone
(732) 442-1666
NPI assigned
May 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 44SC05370200 NJ Primary

Addresses

Primary practice location

570 Lee St
Perth Amboy, NJ 08861-3053

Mailing address

67 Mercury Cir
South Amboy, NJ 08879-2464
Phone (732) 727-3866

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
I20090918000160 NJ Practitioner - Clinical Social Worker 8022164961 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
County of MiddlesexGroup PAC ID 0547165904, 16 clinicians

Practice addresses (Care Compare)

570 Lee St
Perth Amboy, NJ 08861-3053
Phone (980) 442-1666

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
County of Middlesex CurrentSince Jul 1, 2009 Accepting new patients
County of Middlesex CurrentSince Jul 1, 2009 Accepting new patients

Locations

570 Lee St
Perth Amboy, NJ 08861
Phone (732) 442-1666

Organizations & group practices 2

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": "1179014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254268800000",
    "number": "1093920050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67 MERCURY CIR",
            "city": "SOUTH AMBOY",
            "state": "NJ",
            "postal_code": "088792464",
            "telephone_number": "732-727-3866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "570 LEE ST",
            "city": "PERTH AMBOY",
            "state": "NJ",
            "postal_code": "088613053",
            "telephone_number": "732-442-1666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "LORRAINE",
        "middle_name": "FRANCES",
        "name_prefix": "Miss",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-13",
        "last_updated": "2009-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05370200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Perth Amboy, NJ

Sources for this page

Verify at the official NPI Registry.