Doctor profile · Federal record

Dr. Jack Tanenbaum, LCSW

Mental Health Counselor (CMS: Clinical Social Worker) · Lodi, CA

  • NPI 1154419505
  • Accepts Medicare
  • 62 yrs in practice
  • Male
  • Solo practice
  • No sanctions

Practice & contact

NPPES Updated May 11, 2026
Primary practice
1920 Tienda Dr, Ste 101
Lodi, CA 952423930
(916) 662-5947
fax (209) 366-1133
Mailing address
2715 W Kettleman Ln, Ste 203-113
Lodi, CA 952429289

Credentials & registration

NPPES · NUCC
NPI registered
October 2006 — 20 yrs on file
Profile last updated
October 1, 2010
Year of graduation
1964 — 62 yrs since
Specialty taxonomy
101YM0800X — NUCC code
State license (1)
California #LCS 1098

Federal sanctions & exclusions

OIG LEIE Updated May 11, 2026

No sanctions, exclusions or revocations on file

Checked against OIG LEIE on NPI 1154419505. Last verified May 11, 2026.

Medicare procedures · 2023

Top services delivered

CMS Provider Utilization
Total services
127
Distinct HCPCS
1
Medicare allowed
$12,367
HCPCS Description Services Patients Avg allowed
90837 Psychotherapy, 1 hour 127 11 $97

In context: peer comparison

Among 1 peers in Lodi Mental Health Counselor, average services per provider: 127. This provider delivers 1.0× the peer median.

Frequently asked questions

Auto-generated from federal data
What is Dr. Jack Tanenbaum's medical specialty?
Dr. Jack Tanenbaum practices Mental Health Counselor in Lodi, CA.
Where does Dr. Jack Tanenbaum practice?
Dr. Jack Tanenbaum practices at 1920 Tienda Dr, Lodi, CA 952423930. Office phone: 9166625947.
What is Dr. Jack Tanenbaum's NPI?
Dr. Jack Tanenbaum's National Provider Identifier (NPI) is 1154419505, issued by NPPES.
Does Dr. Jack Tanenbaum accept Medicare assignment?
Yes. Dr. Jack Tanenbaum accepts Medicare assignment, meaning Medicare-allowed amounts are accepted as full payment for covered services.
What procedures does Dr. Jack Tanenbaum commonly perform?
Top Medicare-reported procedures in 2023: Psychotherapy (HCPCS 90837). Source: CMS Medicare Physician & Other Practitioners file.