Active NPI
Matilta M Outen
- Social Worker
- Jersey City, NJ
National Provider Identifier
1114200698
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 44SL05091300
- Practice address
- 253 Martin Luther King Jr Dr
Jersey City, NJ 07305-3427 - Phone
- (201) 332-7072
- NPI assigned
- Sep 21, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 44SL05091300 | NJ | Primary |
Addresses
Primary practice location
253 Martin Luther King Jr Dr
Jersey City, NJ 07305-3427
Mailing address
PO Box 3144
Jersey City, NJ 07303-3144
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 44SL05091300 | NJ | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Urban Medical Behavioral Health Services LLC | Past | 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.
-
- Substance Abuse Rehabilitation Facility
- Jersey City, NJ
- NPI 1558643619
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1316563200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1316563200000",
"number": "1114200698",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3144",
"city": "JERSEY CITY",
"state": "NJ",
"postal_code": "073033144"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "253 MARTIN LUTHER KING JR DR",
"city": "JERSEY CITY",
"state": "NJ",
"postal_code": "073053427",
"telephone_number": "201-332-7072"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OUTEN",
"first_name": "MATILTA",
"middle_name": "M",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-09-21",
"last_updated": "2011-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NJ",
"license": "44SL05091300",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jersey City, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.