Ashley Jerzykowski, LSW, RBT

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-26-87762 Issued in IN

Practice address

4609 Grape Rd Ste D1B
Mishawaka, IN 46545-8259

Phone

(574) 217-1624

NPI assigned

Dec 20, 2024

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1734652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786492800000",
    "number": "1043028236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5776 GRAPE RD.",
            "address_2": "PMB 171",
            "city": "MISHWAKA",
            "state": "IN",
            "postal_code": "46545",
            "telephone_number": "574-217-1624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4609 GRAPE RD STE D1B",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465458259",
            "telephone_number": "574-217-1624"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4623 Grape Rd Ste C1",
            "address_purpose": "LOCATION",
            "city": "Mishawaka",
            "state": "IN",
            "postal_code": "465452603",
            "country_code": "US",
            "telephone_number": "574-217-1624",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JERZYKOWSKI",
        "first_name": "ASHLEY",
        "credential": "LSW, RBT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-20",
        "last_updated": "2026-08-12",
        "certification_date": "2026-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "IN",
            "license": "1-26-87762",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IN",
            "license": "33010569A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Behavior Analyst in Mishawaka, IN
• Providers in Mishawaka, IN by specialty
• Behavior Analyst in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.