Katherine Kowalczik, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

092564 Issued in NY

Practice address

397 Bridge St
Brooklyn, NY 11201-5292

Phone

(646) 904-8155

NPI assigned

Dec 5, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jan 6, 2023 through Jan 6, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Avenues Psychotherapy Collective LCSW PLLC

  • Clinical Social Worker
  • Salt Lake City, UT
  • NPI 1144109455
  NPD Authorized official
• Sirona Psychotherapy Licensed Clinical Social Worker Inc.

  • Clinical Social Worker
  • Irvine, CA
  • NPI 1235842519
  NPD Authorized official
• Bridge Back to Life Center

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Brooklyn, NY
  • NPI 1881922508
  NPD (past)
• Bridge Back to Life Center, Inc.

  • Multi-Specialty Clinic/Center
  • Bethpage, NY
  • NPI 1518918101

  Social Worker

  NPD (past)
• Resilience Psychotherapy LCSW PC

  • Clinical Social Worker
  • New York, NY
  • NPI 1003459694
  NPD (past)

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

{
    "created_epoch": "1480896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659398400000",
    "number": "1013451434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19712 MACARTHUR BLVD STE 110",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926122407",
            "telephone_number": "646-904-8155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "397 BRIDGE ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112015292",
            "telephone_number": "646-904-8155"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19712 MacArthur Blvd Ste 110",
            "address_purpose": "LOCATION",
            "city": "Irvine",
            "state": "CA",
            "postal_code": "926122407",
            "country_code": "US",
            "telephone_number": "646-904-8155",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOWALCZIK",
        "first_name": "KATHERINE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-05",
        "last_updated": "2022-08-02",
        "certification_date": "2022-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "1050001",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "108007",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "092564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristina Kovtonyuk
• Ekaterina Kovtun, MD
• Artem Kovyazin, PT,DPT
• Tomasz Wojciech Kowacz, MD
• David Kowal
• Karolina Kowalska, OD
• Harriet Elida Kowalski Seidman, SLP
• Miriam Kowalsky, M.S.
• Shoshana M Kowalsky, LCSW
• Yehuda Kowalsky, MHC

• Clinical Social Worker in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.