Active NPI
Marisa Lutz
- Social Worker
- Rockaway, NJ
National Provider Identifier
1679341713
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 44SL07063900
- Practice address
- 23 Omaha Ave
Rockaway, NJ 07866-1914 - Phone
- (973) 626-5740
- NPI assigned
- Dec 18, 2023
- Last updated
- Dec 18, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Social Worker | 1041S0200X | 01715948 | NJ | |
| Marriage & Family Therapist | 106H00000X | 37FA00040500 | NJ | |
| Social Worker | 104100000X | 44SL07063900 | NJ | Primary |
Addresses
Primary practice location
23 Omaha Ave
Rockaway, NJ 07866-1914
Mailing address
23 Omaha Ave
Rockaway, NJ 07866-1914
Phone (973) 626-5740
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
| License | State | Type | Specialty |
|---|---|---|---|
| 44SL07063900 | NJ | MD | Social Worker |
| 01715948 | NJ | MD | School Social Worker |
| 37FA00040500 | NJ | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1702857600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1702857600000",
"number": "1679341713",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23 OMAHA AVE",
"city": "ROCKAWAY",
"state": "NJ",
"postal_code": "078661914",
"telephone_number": "973-626-5740"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23 OMAHA AVE",
"city": "ROCKAWAY",
"state": "NJ",
"postal_code": "078661914",
"telephone_number": "973-626-5740"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUTZ",
"first_name": "MARISA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-12-18",
"last_updated": "2023-12-18",
"certification_date": "2023-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "1041S0200X",
"taxonomy_group": "",
"desc": "Social Worker, School",
"state": "NJ",
"license": "01715948",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "NJ",
"license": "37FA00040500",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NJ",
"license": "44SL07063900",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.