Provider Demographics
NPI:1841680345
Name:LUTOMSKI, SANDRA (LCSW, LCADC)
Entity type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:
Last Name:LUTOMSKI
Suffix:
Gender:F
Credentials:LCSW, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 US HIGHWAY 202 STE 51050
Mailing Address - Street 2:
Mailing Address - City:RARITAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08869-1352
Mailing Address - Country:US
Mailing Address - Phone:908-510-6914
Mailing Address - Fax:
Practice Address - Street 1:300 US HIGHWAY 202 STE 51050
Practice Address - Street 2:
Practice Address - City:RARITAN
Practice Address - State:NJ
Practice Address - Zip Code:08869-1352
Practice Address - Country:US
Practice Address - Phone:908-510-6914
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-04
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00170600101YA0400X
NJ44SC055967001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)