Mari Brzostowski, LCPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

180005698 Issued in IL

Practice address

3436 N Kennicott Ave
Arlington Heights, IL 60004-7814

Phone

(847) 952-7460

Fax

(847) 222-1754

NPI assigned

Sep 5, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

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.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Alexian Brothers Center for Mental HealthGroup PAC ID 9032019757, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mari.brzostowski.1@21300.direct.athenahealth.com

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.

• Alexian Brothers Center for Mental Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Arlington Heights, IL
  • NPI 1689674038
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593648000000",
    "number": "1023110327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3436 N KENNICOTT AVE",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600047814",
            "telephone_number": "847-952-7460",
            "fax_number": "847-222-1754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3436 N KENNICOTT AVE",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600047814",
            "telephone_number": "847-952-7460",
            "fax_number": "847-222-1754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRZOSTOWSKI",
        "first_name": "MARI",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-05",
        "last_updated": "2020-07-02",
        "certification_date": "2020-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180-005698",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180005698",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID#",
            "identifier": "36-3045007",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Arlington Heights, IL
• Providers in Arlington Heights, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.