Individual provider Active NPI

Irina Shutak

  • Community/Behavioral Health Agency
  • Budd Lake, NJ
National Provider Identifier
1669380739
Registry record updated Aug 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Practice address
4 Village Green
Apt. D
Budd Lake, NJ 07828-1304
Phone
(973) 216-6567
NPI assigned
Aug 31, 2026
Sex
Unspecified or another gender identity
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

4 Village Green
Apt. D
Budd Lake, NJ 07828-1304

Mailing address

4 Village GRN Apt D
Budd Lake, NJ 07828-1304
Phone (973) 216-6567

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1788134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788134400000",
    "number": "1669380739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 VILLAGE GRN APT D",
            "city": "BUDD LAKE",
            "state": "NJ",
            "postal_code": "078281304",
            "telephone_number": "973-216-6567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 VILLAGE GREEN",
            "address_2": "APT. D",
            "city": "BUDD LAKE",
            "state": "NJ",
            "postal_code": "078281304",
            "telephone_number": "973-216-6567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUTAK",
        "first_name": "IRINA",
        "sole_proprietor": "YES",
        "sex": "X",
        "enumeration_date": "2026-08-31",
        "last_updated": "2026-08-31",
        "certification_date": "2026-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Budd Lake, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.