Individual provider Active NPI

Jordyn Czerwinski, MSW

  • Mental Health Counselor
  • Madison, WI
National Provider Identifier
1215318688
Registry record updated Sep 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
702 W Main St
Madison, WI 53715-1424
Phone
(608) 280-2600
NPI assigned
Jun 11, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

702 W Main St
Madison, WI 53715-1424

Mailing address

25 Kessel CT Ste 105
Madison, WI 53711-6227
Phone (608) 280-2700

Other names 1

  • Jordyn Mark Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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

Enrollment IDStateProvider typePAC IDDetails
I20190920000653 WI Practitioner - Clinical Social Worker 4789914565 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Psychology Clinic Inc.Group PAC ID 0143216747, 10 clinicians

Practice addresses (Care Compare)

702 N Blackhawk Ave
Suite 212
Madison, WI 53705-3357
Phone (608) 238-9991

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Psychology Clinic Inc. CurrentSince Sep 1, 2019 Accepting new patients
Kayla Johnson LLC Past Accepting new patients
Journey Mental Health Center, Inc. Past Accepting new patients

Locations

2985 Triverton Pike Dr
Ste 201
Fitchburg, WI 53711
Phone (608) 238-9991

702 N Blackhawk Ave
Ste 212
Madison, WI 53705
Phone (608) 238-9991

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, 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": "1433980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473724800000",
    "number": "1215318688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 KESSEL CT STE 105",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537116227",
            "telephone_number": "608-280-2700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 W MAIN ST",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537151424",
            "telephone_number": "608-280-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CZERWINSKI",
        "first_name": "JORDYN",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-11",
        "last_updated": "2016-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JORDYN",
            "last_name": "MARK",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.