Active NPI
Nancy K Kujawa, LSW LADC
- Addiction (Substance Use Disorder) Counselor
- East Grand Forks, MN
National Provider Identifier
1114194719
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 302314
- Practice address
- 1111 Gateway Dr NE
East Grand Forks, MN 56721-2620 - Phone
- (218) 793-0420
- NPI assigned
- May 13, 2008
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 302314 | MN | Primary |
| Clinical Social Worker | 1041C0700X | 17876 | MN |
Addresses
Primary practice location
1111 Gateway Dr NE
East Grand Forks, MN 56721-2620
Mailing address
1111 Gateway Dr NE
East Grand Forks, MN 56721-2620
Phone (218) 793-0420
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 |
|---|---|---|---|
| 302314 | MN | MD | Addiction (Substance Use Disorder) Counselor |
| 17876 | MN | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1210636800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1405296000000",
"number": "1114194719",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1111 GATEWAY DR NE",
"city": "EAST GRAND FORKS",
"state": "MN",
"postal_code": "567212620",
"telephone_number": "218-793-0420"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1111 GATEWAY DR NE",
"city": "EAST GRAND FORKS",
"state": "MN",
"postal_code": "567212620",
"telephone_number": "218-793-0420"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KUJAWA",
"first_name": "NANCY",
"middle_name": "K",
"credential": "LSW LADC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-05-13",
"last_updated": "2014-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "MN",
"license": "302314",
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MN",
"license": "17876",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in East Grand Forks, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.