Individual provider Active NPI

Linda Ann Ditullio, LCSW

  • Clinical Social Worker
  • Montclair, NJ
National Provider Identifier
1265647184
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC00040400 Issued in NJ
Practice address
10 Erie St
Montclair, NJ 07042-4000
Phone
(973) 744-0012
NPI assigned
May 14, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 44SC00040400 NJ Primary

Addresses

Primary practice location

10 Erie St
Montclair, NJ 07042-4000

Mailing address

11 Lakewood Ave
Cedar Grove, NJ 07009-1507
Phone (973) 857-7407

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
I20050427000040 NJ Practitioner - Clinical Social Worker 8325087638 Practice locations: Montclair, NJ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

8 Hillside Ave
Suite 108 6
Montclair, NJ 07042-2129
Phone (201) 953-0267

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265647184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 LAKEWOOD AVE",
            "city": "CEDAR GROVE",
            "state": "NJ",
            "postal_code": "070091507",
            "telephone_number": "973-857-7407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 ERIE ST",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070424000",
            "telephone_number": "973-744-0012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DITULLIO",
        "first_name": "LINDA",
        "middle_name": "ANN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC00040400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montclair, NJ

Sources for this page

Verify at the official NPI Registry.