Nicole Lyn Kozal, LLMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6851110462 Issued in MI

Practice address

2864 Ashmun St
Sault Sainte Marie, MI 49783-3740

Phone

(906) 635-6075

NPI assigned

Oct 20, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1634688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634688000000",
    "number": "1154084788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2864 ASHMUN ST",
            "city": "SAULT SAINTE MARIE",
            "state": "MI",
            "postal_code": "497833740",
            "telephone_number": "906-635-6075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2864 ASHMUN ST",
            "city": "SAULT SAINTE MARIE",
            "state": "MI",
            "postal_code": "497833740",
            "telephone_number": "906-635-6075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOZAL",
        "first_name": "NICOLE",
        "middle_name": "LYN",
        "credential": "LLMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-20",
        "last_updated": "2021-10-20",
        "certification_date": "2021-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6851110462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Colton Korhonen
• Christina S. Korson, ACSW
• Allison Kotsko
• Abigail Kott
• Teresa A. Kowalski, MSN, FNP-C
• Artina Marie Kreuzer
• Kristin May Krull, LMT
• Nessrine Hussein Ktaich, M.D.
• Karen Kucharczyk
• Kennedy Kunnert, RN

• Clinical Social Worker in Sault Sainte Marie, MI
• Providers in Sault Sainte Marie, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.