Active NPI
Thomas John Zakrzewski, LCSW
- Clinical Social Worker
- Manitowoc, WI
National Provider Identifier
1194874511
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 7452
- Practice address
- Manitowoc County Human Services Department
926 S 8TH Street
Manitowoc, WI 54221-1177 - Phone
- (920) 683-4230
- Fax
- (920) 720-3806
- NPI assigned
- Jan 9, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 149.011635 | IL | |
| Clinical Social Worker | 1041C0700X | 7452 | WI | Primary |
Addresses
Primary practice location
Manitowoc County Human Services Department
926 S 8TH Street
Manitowoc, WI 54221-1177
Mailing address
Manitowoc County Human Services Department
926 S 8TH Street
Manitowoc, WI 54221-1177
Phone (920) 683-4230
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 04932561 | Other | IL | BCBS PPO |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 149.011635 | IL | MD | Clinical Social Worker |
| 7452 | WI | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| GJB Eeg Services, SC | Current | Accepting new patients | |
| Family Services of Northeast Wisconsin Inc | Past | Accepting new patients | |
| Family Services of Northeast Wisconsin Inc | Past | Accepting new patients |
Locations
711 N Lynndale Dr
Ste 1A
Appleton, WI 54914
Phone (920) 217-7861
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
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- NPI 1396315321
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Menasha, WI
- NPI 1275525925
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Green Bay, WI
- NPI 1467453167
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168300800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602720000000",
"number": "1194874511",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "MANITOWOC COUNTY HUMAN SERVICES DEPARTMENT",
"address_2": "926 S 8TH STREET",
"city": "MANITOWOC",
"state": "WI",
"postal_code": "542211177",
"telephone_number": "920-683-4230",
"fax_number": "920-720-3806"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "MANITOWOC COUNTY HUMAN SERVICES DEPARTMENT",
"address_2": "926 S 8TH STREET",
"city": "MANITOWOC",
"state": "WI",
"postal_code": "542211177",
"telephone_number": "920-683-4230",
"fax_number": "920-720-3806"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZAKRZEWSKI",
"first_name": "THOMAS",
"middle_name": "JOHN",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-09",
"last_updated": "2020-10-15",
"certification_date": "2020-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "149.011635",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WI",
"license": "7452",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PPO",
"identifier": "04932561",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Manitowoc, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.