Active NPI
Jack Lu, LCSW, MSW
- Clinical Social Worker
- Prospect, CT
National Provider Identifier
1336369172
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 006540
- Practice address
- 44 Waterbury Rd
Suite 2C
Prospect, CT 06712-1242 - Phone
- (860) 878-5648
- NPI assigned
- Apr 26, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 006540 | CT | Primary |
Addresses
Primary practice location
44 Waterbury Rd
Suite 2C
Prospect, CT 06712-1242
Mailing address
44 Waterbury Rd
Suite 2C
Prospect, CT 06712-1242
Phone (860) 878-5648
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1424131200000",
"number": "1336369172",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "44 WATERBURY RD",
"address_2": "SUITE 2C",
"city": "PROSPECT",
"state": "CT",
"postal_code": "067121242",
"telephone_number": "860-878-5648"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "44 WATERBURY RD",
"address_2": "SUITE 2C",
"city": "PROSPECT",
"state": "CT",
"postal_code": "067121242",
"telephone_number": "860-878-5648"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LU",
"first_name": "JACK",
"name_prefix": "Mr.",
"credential": "LCSW, MSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-26",
"last_updated": "2015-02-17",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CT",
"license": "006540",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Prospect, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 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.