Individual provider Active NPI

Lori A Dritz, LCSW

  • Clinical Social Worker
  • Poughkeepsie, NY
National Provider Identifier
1588796759
Registry record updated Dec 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R031263-1 Issued in NY
Practice address
21 Fairmont Ave
Suite #2
Poughkeepsie, NY 12603-2409
Phone
(845) 452-4030
Fax
(845) 297-0224
NPI assigned
Mar 12, 2007
Last updated
Dec 8, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 8, 2011

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 R031263-1 NY Primary

Addresses

Primary practice location

21 Fairmont Ave
Suite #2
Poughkeepsie, NY 12603-2409

Mailing address

3 Cleveland Dr
Poughkeepsie, NY 12601-6001
Phone (845) 298-0264

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20130425000222 NY Practitioner - Clinical Social Worker 8527204205 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3 Cleveland Dr
Poughkeepsie, NY 12601-6001

504 Haight Ave
Poughkeepsie, NY 12603-2479
Phone (845) 242-3623

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R031263-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Lori a Dritz LCSW PC CurrentSince Jan 1, 2013 Accepting new patients
Mid-Hudson Behavioral Health Group-LCSW, LLP Current Accepting new patients

Locations

504 Haight Ave
Poughkeepsie, NY 12603
Phone (845) 242-3623

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323302400000",
    "number": "1588796759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 CLEVELAND DR",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126016001",
            "telephone_number": "845-298-0264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 FAIRMONT AVE",
            "address_2": "SUITE #2",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126032409",
            "telephone_number": "845-452-4030",
            "fax_number": "845-297-0224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRITZ",
        "first_name": "LORI",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-12",
        "last_updated": "2011-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R031263-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poughkeepsie, NY

Sources for this page

Verify at the official NPI Registry.