Individual provider Active NPI

Brittany Lautzenheiser, LCSW

  • Clinical Social Worker
  • Middleburg, FL
National Provider Identifier
1982075016
Registry record updated Dec 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
4579 Pine Ridge Pkwy
Middleburg, FL 32068-9124
Phone
(201) 317-5753
NPI assigned
Oct 15, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 16, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X NJ
Clinical Social Worker 1041C0700X 44SC06095000 NJ
Clinical Social Worker 1041C0700X CW022242 PA
Clinical Social Worker 1041C0700X FL Primary

Addresses

Primary practice location

4579 Pine Ridge Pkwy
Middleburg, FL 32068-9124

Mailing address

4579 Pine Ridge Pkwy
Middleburg, FL 32068-9124
Phone (201) 317-5753

Other identifiers 1

IdentifierTypeStateIssuer
0023701MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, FL, NJ3 enrollments
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20220531001973 PA Practitioner - Clinical Social Worker 0941688154 Reassigns benefits to 2 organizations
I20240822002127 FL Practitioner - Clinical Social Worker 0941688154 Reassigns benefits to 1 organization
I20250509001192 NJ Practitioner - Clinical Social Worker 0941688154 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44SC06095000NJMDClinical Social Worker
CW022242PAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic CurrentSince May 23, 2022 Accepting new patients
Geisinger Clinic CurrentSince May 23, 2022 Accepting new patients
Geisinger Clinic Current Accepting new patients
Grow Healthcare Group of New Jersey PC Mental Health CurrentSince Apr 15, 2025 Accepting new patients
Grow Healthcare Group PA Mental Health CurrentSince Apr 9, 2025 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

221 River St
Ste 9
Hoboken, NJ 07030
Phone (201) 439-8902

100 N Academy Ave
Danville, PA 17822

1626 Locust St
Philadelphia, PA 19103
Phone (215) 709-3177

Organizations & group practices 5

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": "1444867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734307200000",
    "number": "1982075016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4579 PINE RIDGE PKWY",
            "city": "MIDDLEBURG",
            "state": "FL",
            "postal_code": "320689124",
            "telephone_number": "201-317-5753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4579 PINE RIDGE PKWY",
            "city": "MIDDLEBURG",
            "state": "FL",
            "postal_code": "320689124",
            "telephone_number": "201-317-5753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAUTZENHEISER",
        "first_name": "BRITTANY",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-15",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NJ",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC06095000",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW022242",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0023701",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middleburg, FL

Sources for this page

Verify at the official NPI Registry.