Individual provider Active NPI

Elizabeth Ann Gryczko-Drazien, LMSW, LSW,LCSW

  • Clinical Social Worker
  • Harrisburg, PA
National Provider Identifier
1306917414
Registry record updated Feb 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW016650 Issued in PA
Practice address
2023 N 2ND St
Suite 112
Harrisburg, PA 17102-2151
Phone
(570) 575-6971
NPI assigned
Nov 11, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 8, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X SW127810 PA
Clinical Social Worker 1041C0700X CW016650 PA Primary

Addresses

Primary practice location

2023 N 2ND St
Suite 112
Harrisburg, PA 17102-2151

Mailing address

2023 N 2ND St
Suite 112
Harrisburg, PA 17102-2151
Phone (570) 575-6971

Other identifiers 1

IdentifierTypeStateIssuer
1024474770001MedicaidPA

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

LicenseStateTypeSpecialty
SW127810PAMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1163203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454889600000",
    "number": "1306917414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2023 N 2ND ST",
            "address_2": "SUITE 112",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171022151",
            "telephone_number": "570-575-6971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2023 N 2ND ST",
            "address_2": "SUITE 112",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171022151",
            "telephone_number": "570-575-6971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRYCZKO-DRAZIEN",
        "first_name": "ELIZABETH",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "LMSW, LSW,LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-11",
        "last_updated": "2016-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "PA",
            "license": "SW127810",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW016650",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1024474770001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrisburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2016; 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.