Individual provider Active NPI

Jennifer Stytzer, LCSW

  • Clinical Social Worker
  • Montrose, NY
National Provider Identifier
1164504841
Registry record updated Oct 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
076677 Issued in NY
Practice address
2094 Albany Post Rd
Montrose, NY 10548-1454
Phone
(914) 737-4400
Fax
(914) 788-4223
NPI assigned
Oct 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 076677 NY Primary
Clinical Social Worker 1041C0700X 074094 NY

Addresses

Primary practice location

2094 Albany Post Rd
Montrose, NY 10548-1454

Mailing address

2094 Albany Post Rd
Montrose, NY 10548-1454
Phone (914) 737-4400

Other identifiers 2

IdentifierTypeStateIssuer
1285628552OtherNYAGENCY NPI
00355940MedicaidNY

Other names 1

  • Jennifer Mueller Former name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
074094NYMDClinical Social Worker
076677NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Julia Dyckman Andrus Memorial, Inc. PastSince Apr 1, 2005 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": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445817600000",
    "number": "1164504841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2094 ALBANY POST RD",
            "city": "MONTROSE",
            "state": "NY",
            "postal_code": "105481454",
            "telephone_number": "914-737-4400",
            "fax_number": "914-788-4223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2094 ALBANY POST RD",
            "city": "MONTROSE",
            "state": "NY",
            "postal_code": "105481454",
            "telephone_number": "914-737-4400",
            "fax_number": "914-788-4223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STYTZER",
        "first_name": "JENNIFER",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-20",
        "last_updated": "2015-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "076677",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "074094",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AGENCY NPI",
            "identifier": "1285628552",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00355940",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "MUELLER",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Montrose, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.