Individual provider Active NPI

Maureen Ilise Kritzer-Lange, MSW, LCSW

  • Clinical Social Worker
  • Maplewood, NJ
National Provider Identifier
1619193372
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC04379700 Issued in NJ
Practice address
35 Maplewood Ave
Maplewood, NJ 07040-1219
Phone
(973) 313-1691
Fax
(973) 313-1692
NPI assigned
Apr 18, 2007
Sex
Female
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 44SC04379700 NJ Primary

Addresses

Primary practice location

35 Maplewood Ave
Maplewood, NJ 07040-1219

Mailing address

35 Maplewood Ave
Maplewood, NJ 07040-1219
Phone (973) 313-1691

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
I20101208000104 NJ Practitioner - Clinical Social Worker 6901093640 Practice locations: South Orange, NJ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

153 Valley St
Unit 207
South Orange, NJ 07079-2842
Phone (973) 313-1691

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44SC04379700NJMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619193372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 MAPLEWOOD AVE",
            "city": "MAPLEWOOD",
            "state": "NJ",
            "postal_code": "070401219",
            "telephone_number": "973-313-1691",
            "fax_number": "973-313-1692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 MAPLEWOOD AVE",
            "city": "MAPLEWOOD",
            "state": "NJ",
            "postal_code": "070401219",
            "telephone_number": "973-313-1691",
            "fax_number": "973-313-1692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRITZER-LANGE",
        "first_name": "MAUREEN",
        "middle_name": "ILISE",
        "name_prefix": "Ms.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC04379700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maplewood, NJ

Sources for this page

Verify at the official NPI Registry.