Kristen Misiak, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

001301 Issued in CT

Practice address

1046 Fairfield Ave
Bridgeport, CT 06605-1116

Phone

(203) 330-6054

Fax

(203) 331-4716

NPI assigned

Jun 1, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1180656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431388800000",
    "number": "1326240482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1046 FAIRFIELD AVE",
            "address_2": "1046 FAIRFIELD AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066051116",
            "telephone_number": "203-330-6054",
            "fax_number": "203-331-4716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1046 FAIRFIELD AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066051116",
            "telephone_number": "203-330-6054",
            "fax_number": "203-331-4716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISIAK",
        "first_name": "KRISTEN",
        "name_prefix": "Miss",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-01",
        "last_updated": "2015-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CT",
            "license": "001301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Miraclehands LLC
• Mark Anthony Patatag Miranda Jr.
• Wendy Priya Miranda, M.D
• Mehwish Mirza, MD
• Amit Mishra, MD
• Kimberly Susan Misiaszek, PHYSICAL THERAPIST
• Monique Misra, MD
• Matthew Mitchell, MD
• Michele Lynn Mitchell
• Vanessa Mix

• Social Worker in Bridgeport, CT
• Providers in Bridgeport, CT by specialty
• Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2015; 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.