John Wyetzner, LSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SL06613000 Issued in NJ

Practice address

333 Main St Ste 200
Madison, NJ 07940-2370

Phone

(646) 457-0735

NPI assigned

Dec 2, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1606867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606867200000",
    "number": "1770188344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 MAIN ST STE 200",
            "city": "MADISON",
            "state": "NJ",
            "postal_code": "079402370",
            "telephone_number": "646-457-0735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 MAIN ST STE 200",
            "city": "MADISON",
            "state": "NJ",
            "postal_code": "079402370",
            "telephone_number": "646-457-0735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYETZNER",
        "first_name": "JOHN",
        "credential": "LSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-12-02",
        "last_updated": "2020-12-02",
        "certification_date": "2020-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SL06613000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kerstin Elisabeth White, L.P.C.
• Jenifer M. Wilcher, LCSW
• Kelly Elizabeth Winans, DPT
• Priscilla Wong, DACM, L.AC.
• Christopher Scott Wyckoff, D.M.D.
• Young Men's Christian Association of Madison, N.J. (Madison Area YMCA)
• Henry Patrick Zwick

• Clinical Social Worker in Madison, NJ
• Providers in Madison, NJ by specialty
• Clinical Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2020; 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.