Individual provider Active NPI

Brajan Kajetan Kowalski, RCSWI

  • Social Worker
  • Sarasota, FL
National Provider Identifier
1174361646
Registry record updated Aug 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
ISW20560 Issued in FL
Practice address
4837 Swift Rd Ste 110-9
Sarasota, FL 34231-5182
Phone
(614) 500-3889
NPI assigned
Jul 18, 2024
Last updated
Aug 3, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X ISW20560 FL Primary

Addresses

Primary practice location

4837 Swift Rd Ste 110-9
Sarasota, FL 34231-5182

Mailing address

2539 River Preserve CT
Bradenton, FL 34208-7464
Phone (941) 363-1442

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

LicenseStateTypeSpecialty
ISW20560FLMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Kelli Skaggs LCSW LLC CurrentSince Nov 10, 2024 Accepting new patients

Locations

4837 Swift Rd
Ste 1109
Sarasota, FL 34231
Phone (614) 500-3889

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1721260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722643200000",
    "number": "1174361646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2539 RIVER PRESERVE CT",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342087464",
            "telephone_number": "941-363-1442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4837 SWIFT RD STE 110-9",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342315182",
            "telephone_number": "614-500-3889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOWALSKI",
        "first_name": "BRAJAN",
        "middle_name": "KAJETAN",
        "credential": "RCSWI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-18",
        "last_updated": "2024-08-03",
        "certification_date": "2024-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "FL",
            "license": "ISW20560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sarasota, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2024; 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.