Individual provider Active NPI

Daniel Jon Lundquist, MSW, LCSW

  • Clinical Social Worker
  • Pennington, NJ
National Provider Identifier
1457578460
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC00038900 Issued in NJ
Practice address
114 Straube Center Blvd
#K195
Pennington, NJ 08534-1450
Phone
(609) 737-2704
NPI assigned
Apr 19, 2007
Sex
Male
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 44SC00038900 NJ Primary

Addresses

Primary practice location

114 Straube Center Blvd
#K195
Pennington, NJ 08534-1450

Mailing address

114 Straube Center Blvd
#K195
Pennington, NJ 08534-1450
Phone (609) 737-2704

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
I20050505000061 NJ Practitioner - Clinical Social Worker 9537109939 Practice locations: Pennington, NJ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

114 Straube Ctr Blvd
K195
Pennington, NJ 08534-1450
Phone (609) 737-2704

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44SC00038900NJMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1457578460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 STRAUBE CENTER BLVD",
            "address_2": "#K195",
            "city": "PENNINGTON",
            "state": "NJ",
            "postal_code": "085341450",
            "telephone_number": "609-737-2704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 STRAUBE CENTER BLVD",
            "address_2": "#K195",
            "city": "PENNINGTON",
            "state": "NJ",
            "postal_code": "085341450",
            "telephone_number": "609-737-2704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUNDQUIST",
        "first_name": "DANIEL",
        "middle_name": "JON",
        "name_prefix": "Mr.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC00038900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pennington, NJ

Sources for this page

Verify at the official NPI Registry.