Individual provider Active NPI

Ana Lutenberg, LICSW

  • Clinical Social Worker
  • Waltham, MA
National Provider Identifier
1467853887
Registry record updated Feb 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
000225350 Issued in MA
Practice address
77 Rumford Ave
Children'S Charter
Waltham, MA 02453-3872
Phone
(781) 894-4325
Fax
(781) 894-1195
NPI assigned
Sep 5, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 14, 2025

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 000225350 MA Primary

Addresses

Primary practice location

77 Rumford Ave
Children'S Charter
Waltham, MA 02453-3872

Mailing address

77 Rumford Ave
Key Program/Children'S Charter
Waltham, MA 02453-3872
Phone (781) 894-4325

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
000225350MAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1409875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739491200000",
    "number": "1467853887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 RUMFORD AVE",
            "address_2": "KEY PROGRAM/CHILDREN'S CHARTER",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024533872",
            "telephone_number": "781-894-4325",
            "fax_number": "781-894-1195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 RUMFORD AVE",
            "address_2": "CHILDREN'S CHARTER",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024533872",
            "telephone_number": "781-894-4325",
            "fax_number": "781-894-1195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUTENBERG",
        "first_name": "ANA",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-05",
        "last_updated": "2025-02-14",
        "certification_date": "2025-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "000225350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waltham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2025; 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.