Individual provider Active NPI

Jared Tactuk, LCSW

  • Clinical Social Worker
  • Clifton, NJ
National Provider Identifier
1164032652
Registry record updated Feb 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC05882900 Issued in NJ
Practice address
95 Main Ave Ste 278
Clifton, NJ 07014-1748
Phone
(973) 692-5127
Fax
(973) 807-1992
NPI assigned
Aug 9, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 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 44SC05882900 NJ Primary

Addresses

Primary practice location

95 Main Ave Ste 278
Clifton, NJ 07014-1748

Mailing address

95 Main Ave Ste 278
Clifton, NJ 07014-1748
Phone (973) 692-5127

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Self Counseling LLC CurrentSince Feb 9, 2025 Accepting new patients
Curamind LLC Clinical Current Accepting new patients
PHC of Buffalo Grove Clinical Psychology Past Accepting new patients

Locations

95 Main Ave
Ste 278
Clifton, NJ 07014
Phone (973) 692-5127

Organizations & group practices 3

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": "1596931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738713600000",
    "number": "1164032652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 MAIN AVE STE 278",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070141748",
            "telephone_number": "973-692-5127",
            "fax_number": "973-807-1992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 MAIN AVE STE 278",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070141748",
            "telephone_number": "973-692-5127",
            "fax_number": "973-807-1992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TACTUK",
        "first_name": "JARED",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-09",
        "last_updated": "2025-02-05",
        "certification_date": "2025-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05882900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clifton, NJ

Sources for this page

Verify at the official NPI Registry.