Active NPI
Ronnie Israelson Brzezinski, LCSW
- Clinical Social Worker
- Cheshire, CT
National Provider Identifier
1104936814
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 839
- Practice address
- 355 Highland Ave
Suite 101
Cheshire, CT 06410-2551 - Phone
- (860) 628-9259
- Fax
- (860) 628-7674
- NPI assigned
- Aug 30, 2006
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 839 | CT | Primary |
Addresses
Primary practice location
355 Highland Ave
Suite 101
Cheshire, CT 06410-2551
Mailing address
20 November LN
Plantsville, CT 06479-1017
Phone (860) 628-7674
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P400574 | Other | CT | OXFORD |
| 140000839CT01 | Other | CT | ANTHEM BLUE CROSS/BLUE SH |
| 7496215 | Other | CT | VALUE OPTIONS |
Other names 1
- Mrs. Ronnie I. Brzezinski
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 |
|---|---|---|---|
| 839 | CT | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1104936814",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20 NOVEMBER LN",
"city": "PLANTSVILLE",
"state": "CT",
"postal_code": "064791017",
"telephone_number": "860-628-7674",
"fax_number": "860-628-7674"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "355 HIGHLAND AVE",
"address_2": "SUITE 101",
"city": "CHESHIRE",
"state": "CT",
"postal_code": "064102551",
"telephone_number": "860-628-9259",
"fax_number": "860-628-7674"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRZEZINSKI",
"first_name": "RONNIE",
"middle_name": "ISRAELSON",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CT",
"license": "839",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD",
"identifier": "P400574",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BLUE CROSS/BLUE SH",
"identifier": "140000839CT01",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS",
"identifier": "7496215",
"state": "CT"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "RONNIE",
"last_name": "BRZEZINSKI",
"middle_name": "I.",
"prefix": "MRS.",
"credential": "LCSW",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Cheshire, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.