Individual provider Active NPI

Eileen C. Lutz, RN,LCSW,LCADC

  • Clinical Social Worker
  • Warren, NJ
National Provider Identifier
1750584892
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC00172900 Issued in NJ
Practice address
65 Mountain Blvd Ext
Warren, NJ 07059-2632
Phone
(732) 356-5665
Fax
(732) 356-0507
NPI assigned
Jun 7, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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 44SC00172900 NJ Primary

Addresses

Primary practice location

65 Mountain Blvd Ext
Warren, NJ 07059-2632

Mailing address

6 Quill Pen Way
Warren, NJ 07059-5518
Phone (908) 647-0479

Other identifiers 2

IdentifierTypeStateIssuer
NR32823OtherNJREGISTERED NURSE
44SC00172900OtherNJLIC. CLINIC. SOC. WORKER

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)
Enrolled
Credentials
Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Hearclear Hearing Center LLC Past Accepting new patients
William R. Nadel, M.D., PA Past Accepting new patients
Karen Stage Opdyke, MD, PC Past Accepting new patients

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1181174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1750584892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 QUILL PEN WAY",
            "city": "WARREN",
            "state": "NJ",
            "postal_code": "070595518",
            "telephone_number": "908-647-0479",
            "fax_number": "908-647-2592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 MOUNTAIN BLVD EXT",
            "city": "WARREN",
            "state": "NJ",
            "postal_code": "070592632",
            "telephone_number": "732-356-5665",
            "fax_number": "732-356-0507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUTZ",
        "first_name": "EILEEN",
        "middle_name": "C.",
        "credential": "RN,LCSW,LCADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-07",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC00172900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED NURSE",
            "identifier": "NR32823",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIC. CLINIC. SOC. WORKER",
            "identifier": "44SC00172900",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.

Verify at the official NPI Registry.