Individual provider Active NPI

Jacquelyn Ann Lanterman, S.W.

  • Clinical Social Worker
  • Mineral Ridge, OH
National Provider Identifier
1346367919
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
S.0022544 Issued in OH
Practice address
1044 Reservoir Run
Mineral Ridge, OH 44440-9016
Phone
(330) 652-0493
NPI assigned
Mar 26, 2007
Sex
Female
Sole proprietor
No

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 S.0022544 OH Primary

Addresses

Primary practice location

1044 Reservoir Run
Mineral Ridge, OH 44440-9016

Mailing address

1044 Reservoir Run
Mineral Ridge, OH 44440-9016
Phone (330) 652-0493

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
S.0022544OHMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1346367919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1044 RESERVOIR RUN",
            "city": "MINERAL RIDGE",
            "state": "OH",
            "postal_code": "444409016",
            "telephone_number": "330-652-0493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1044 RESERVOIR RUN",
            "city": "MINERAL RIDGE",
            "state": "OH",
            "postal_code": "444409016",
            "telephone_number": "330-652-0493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANTERMAN",
        "first_name": "JACQUELYN",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "S.W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "S.0022544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mineral Ridge, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.