Individual provider Active NPI

Jennifer R. Lusetti, LISW-SUPV

  • Clinical Social Worker
  • Newark, OH
National Provider Identifier
1154844280
Registry record updated Sep 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
68 W Church St Ste 203
Newark, OH 43055-5050
Phone
(740) 934-6474
Fax
(740) 934-6473
NPI assigned
Jul 20, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2025

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 Primary

Addresses

Primary practice location

68 W Church St Ste 203
Newark, OH 43055-5050

Mailing address

68 W Church St Ste 203
Newark, OH 43055-5050
Phone (740) 934-6474

Other identifiers 2

IdentifierTypeStateIssuer
0293779MedicaidOH
I.2102780-SUPVOtherOHOHIO COUNSELOR, SOCIAL WORKER & MFT BOARD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20210811003659 OH Practitioner - Clinical Social Worker 0446654537 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Ohio State University College of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

68 W Church St
Suite 203
Newark, OH 43055-5050
Phone (740) 934-6474

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Alpha Medical Services, LLC CurrentSince Oct 1, 2021 Accepting new patients
New Leaf Behavioral Health Assoc CurrentSince Jul 21, 2024 Accepting new patients

Locations

594 Newark Granville Rd
Granville, OH 43023
Phone (740) 587-1361

68 W Church St
Ste 203
Newark, OH 43055
Phone (740) 934-6474

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": "1500508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759190400000",
    "number": "1154844280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "68 W CHURCH ST STE 203",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430555050",
            "telephone_number": "740-934-6474",
            "fax_number": "740-934-6473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "68 W CHURCH ST STE 203",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430555050",
            "telephone_number": "740-934-6474",
            "fax_number": "740-934-6473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUSETTI",
        "first_name": "JENNIFER",
        "middle_name": "R.",
        "credential": "LISW-SUPV",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-20",
        "last_updated": "2025-09-30",
        "certification_date": "2025-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0293779",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO COUNSELOR, SOCIAL WORKER & MFT BOARD",
            "identifier": "I.2102780-SUPV",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, OH

Sources for this page

Verify at the official NPI Registry.