Individual provider Active NPI

Lauren Luppino, LCSW

  • Clinical Social Worker
  • Ridgewood, NJ
National Provider Identifier
1972828507
Registry record updated Nov 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SC05422500 Issued in NJ
Practice address
10 Wilsey SQ Ste 274
Ridgewood, NJ 07450-3787
Phone
(201) 483-7864
NPI assigned
Apr 7, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 22, 2019

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 SC05422500 NJ Primary

Addresses

Primary practice location

10 Wilsey SQ Ste 274
Ridgewood, NJ 07450-3787

Mailing address

10 Wilsey SQ Ste 274
Ridgewood, NJ 07450-3787
Phone (201) 483-7864

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100517000843 NJ Practitioner - Clinical Social Worker 9739217498 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2007
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Mental Health and Wellness Center LLCGroup PAC ID 2163736992, 2 clinicians

Practice addresses (Care Compare)

71 Franklin Ave
Midland Park, NJ 07432-1919
Phone (201) 483-7864

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SC05422500NJMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health & Wellness Center LLC Clinical CurrentSince Jul 21, 2015 Accepting new patients

Locations

481 Kinderkamack Rd
Oradell, NJ 07649
Phone (201) 599-0101

Organizations & group practices 1

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": "1270598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574380800000",
    "number": "1972828507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 WILSEY SQ STE 274",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074503787",
            "telephone_number": "201-483-7864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 WILSEY SQ STE 274",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074503787",
            "telephone_number": "201-483-7864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUPPINO",
        "first_name": "LAUREN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-07",
        "last_updated": "2019-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "SC05422500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgewood, NJ

Sources for this page

Verify at the official NPI Registry.