Active NPI
Brigid Nalewajka
- Social Worker
- Centralia, IL
National Provider Identifier
1104378637
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 150015517
- Practice address
- 904 E Martin Luther King Drive
Centralia, IL 62801-3058 - Phone
- (618) 533-1391
- Fax
- (618) 533-0012
- NPI assigned
- Nov 1, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 150015517 | IL | Primary |
Addresses
Primary practice location
904 E Martin Luther King Drive
Centralia, IL 62801-3058
Mailing address
904 E Martin Luther King Drive
Centralia, IL 62801-3058
Phone (618) 533-1391
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 370915481007 | Medicaid | IL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 150015517 | IL | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1477958400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1477958400000",
"number": "1104378637",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "904 E MARTIN LUTHER KING DRIVE",
"city": "CENTRALIA",
"state": "IL",
"postal_code": "628013058",
"telephone_number": "618-533-1391",
"fax_number": "618-533-0012"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "904 E MARTIN LUTHER KING DRIVE",
"city": "CENTRALIA",
"state": "IL",
"postal_code": "628013058",
"telephone_number": "618-533-1391",
"fax_number": "618-533-0012"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NALEWAJKA",
"first_name": "BRIGID",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-11-01",
"last_updated": "2016-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "IL",
"license": "150015517",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "370915481007",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Centralia, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.