Individual provider Active NPI

Nicole Lutin, LCSW

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1477963387
Registry record updated May 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
081968 Issued in NY
Practice address
80 N Moore St
Apt 4N
New York, NY 10013-2701
Phone
(617) 548-4646
NPI assigned
Apr 30, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 1, 2018

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 081968 NY Primary

Addresses

Primary practice location

80 N Moore St
Apt 4N
New York, NY 10013-2701

Mailing address

80 N Moore St
Apt 4N
New York, NY 10013-2701
Phone (617) 548-4646

Other names 1

  • Nicole Shribman Former name

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": "1398816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525132800000",
    "number": "1477963387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 N MOORE ST",
            "address_2": "APT 4N",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100132701",
            "telephone_number": "617-548-4646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 N MOORE ST",
            "address_2": "APT 4N",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100132701",
            "telephone_number": "617-548-4646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUTIN",
        "first_name": "NICOLE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-30",
        "last_updated": "2018-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "081968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "SHRIBMAN",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2018; 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.