Individual provider Active NPI

Lynet Uttal, LCSW, MSW, PHD, BS

  • Clinical Social Worker
  • Madison, WI
National Provider Identifier
1396126769
Registry record updated Mar 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
9374-123 Issued in WI
Practice address
49 Kessel CT
Madison, WI 53711-6200
Phone
(608) 280-2672
NPI assigned
Jun 11, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2022

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 9374-123 WI Primary

Addresses

Primary practice location

49 Kessel CT
Madison, WI 53711-6200

Mailing address

49 Kessel CT
Madison, WI 53711-6200
Phone (608) 280-2672

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20201005000070 WI Practitioner - Clinical Social Worker 6305265752 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Journey Mental Health Center IncGroup PAC ID 6406844661, 16 clinicians

Practice addresses (Care Compare)

49 Kessel CT
Madison, WI 53711-6200
Phone (608) 280-2700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor of Science, Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Journey Mental Health Center, Inc. CurrentSince May 6, 2020 Accepting new patients

Locations

25 Kessel Ct
Ste 105
Madison, WI 53711
Phone (608) 280-2636

49 Kessel Ct
Madison, WI 53711
Phone (608) 280-2510

625 W Washington Ave
Madison, WI 53703
Phone (608) 280-2636

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": "1433980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647302400000",
    "number": "1396126769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 KESSEL CT",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537116200",
            "telephone_number": "608-280-2672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49 KESSEL CT",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537116200",
            "telephone_number": "608-280-2672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UTTAL",
        "first_name": "LYNET",
        "credential": "LCSW, MSW, PHD, BS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-11",
        "last_updated": "2022-03-15",
        "certification_date": "2022-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "9374-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.