Organization Active NPI

Lifecycle Therapeutic Services Limited Liability Company

  • Clinical Social Worker
  • Nutley, NJ
National Provider Identifier
1700132933
Registry record updated Jul 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
LIFECYCLE THERAPEUTIC SERVICES LIMITED LIABILITY COMPANY
Practice address
349 Franklin Ave
Suite 201
Nutley, NJ 07110-4004
Phone
(973) 517-4062
NPI assigned
Jul 25, 2012
Last updated
Jul 31, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2012

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

Authorized official

Name
Amanda Levy, LCSW
Title
Executive Director
Phone
(973) 571-4062

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 104100000X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

349 Franklin Ave
Suite 201
Nutley, NJ 07110-4004

Mailing address

349 Franklin Ave
Suite 201
Nutley, NJ 07110-4004
Phone (973) 517-4062

National Provider Directory

National Provider Directory
Tax ID family
Lifecycle Therapeutic Services Limited Liability Company2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

349 Franklin Ave
Ste 201
Nutley, NJ 07110
Phone (973) 517-4062

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1343174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343692800000",
    "number": "1700132933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "349 FRANKLIN AVE",
            "address_2": "SUITE 201",
            "city": "NUTLEY",
            "state": "NJ",
            "postal_code": "071104004",
            "telephone_number": "973-517-4062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "349 FRANKLIN AVE",
            "address_2": "SUITE 201",
            "city": "NUTLEY",
            "state": "NJ",
            "postal_code": "071104004",
            "telephone_number": "973-517-4062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFECYCLE THERAPEUTIC SERVICES LIMITED LIABILITY COMPANY",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-25",
        "last_updated": "2012-07-31",
        "status": "A",
        "authorized_official_last_name": "LEVY",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "973-571-4062",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nutley, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2012; 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.