Individual provider Active NPI

Brianna Marie Earomirski, LCSW

  • Clinical Social Worker
  • Hanover, PA
National Provider Identifier
1003158395
Registry record updated Sep 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW020429 Issued in PA
Practice address
11 Carlisle St Unit 308
Hanover, PA 17331-2472
Phone
(717) 356-0515
NPI assigned
Mar 25, 2013
Last updated
Sep 27, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2021

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 CW020429 PA Primary

Addresses

Primary practice location

11 Carlisle St Unit 308
Hanover, PA 17331-2472

Mailing address

2050 Waterfall Dr
Hanover, PA 17331-8238

Other names 1

  • Brianna Marie Czyz Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Previously, effective Aug 20, 2024 through Aug 20, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CW020429PAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Breathe Intentionally LLC CurrentSince Mar 1, 2023 Accepting new patients
Polaris Detox LLC Past Accepting new patients

Locations

11 Carlisle St
Unit 308
Hanover, PA 17331
Phone (717) 356-0515

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1364169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632700800000",
    "number": "1003158395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2050 WATERFALL DR",
            "city": "HANOVER",
            "state": "PA",
            "postal_code": "173318238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 CARLISLE ST UNIT 308",
            "city": "HANOVER",
            "state": "PA",
            "postal_code": "173312472",
            "telephone_number": "717-356-0515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EAROMIRSKI",
        "first_name": "BRIANNA",
        "middle_name": "MARIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-25",
        "last_updated": "2021-09-27",
        "certification_date": "2021-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW020429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRIANNA",
            "last_name": "CZYZ",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hanover, PA

Sources for this page

Verify at the official NPI Registry.