Jack Tanenbaum, LCSW
NPI 1154419505 · Mental Health Counselor · Lodi, CA
Enrolled with Medicare as Practitioner - Clinical Social Worker · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Jack Tanenbaum, LCSW is a Mental Health Counselor provider in Lodi, CA (NPI 1154419505).
Provider details
- NPI number
- 1154419505
- Entity type
- Individual
- Primary specialty
- Mental Health CounselorBehavioral Health & Social Service Providers
- Credential
- LCSW
- Sex
- Male
- Sole proprietor
- Yes
- License
- LCS 1098 (CA)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2006-10-11
- Last updated
- 2010-10-01
Frequently asked questions
- What is Jack Tanenbaum's NPI number?
- Jack Tanenbaum's National Provider Identifier (NPI) is 1154419505, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Jack Tanenbaum's specialty?
- Jack Tanenbaum is listed in the NPPES registry with a primary specialty of Mental Health Counselor (Behavioral Health & Social Service Providers).
- Where is Jack Tanenbaum located?
- Jack Tanenbaum's practice location on file with NPPES is 1920 Tienda Dr, Lodi, CA 95242-3930.
- What is Jack Tanenbaum's phone number?
- The practice phone number listed in the NPPES registry for Jack Tanenbaum is (916) 662-5947.
- Does Jack Tanenbaum accept Medicare?
- Jack Tanenbaum is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Jack Tanenbaum's NPI active?
- Yes — Jack Tanenbaum's NPI (1154419505) is active in the NPPES registry as of the last update on 2010-10-01.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.