Matthew Ksiazk, LISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I.1700091 Issued in OH

Practice address

825 Grandview Ave
Columbus, OH 43215-1123

Phone

(614) 258-9927

NPI assigned

Mar 28, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Providers for Healthy Living

  • Psychiatry Physician
  • Columbus, OH
  • NPI 1083905830
  NPD (past)
• Providers for Healthy Living

  • Psychiatry Physician
  • Hilliard, OH
  • NPI 1811560899
  NPD (past)

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

{
    "created_epoch": "1490659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490659200000",
    "number": "1386176493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3991 KUL CIR S",
            "city": "HILLIARD",
            "state": "OH",
            "postal_code": "430263854",
            "telephone_number": "440-315-0723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 GRANDVIEW AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432151123",
            "telephone_number": "614-258-9927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KSIAZK",
        "first_name": "MATTHEW",
        "name_prefix": "Mr.",
        "credential": "LISW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-03-28",
        "last_updated": "2017-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1700091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly A Kruthaup
• Andrew Krutilla
• Cynthia Kryc, RPH
• Elizabeth Kryszak, PHD
• Stephanie S. Krznarich, LISW-S, LCDC III,
• Nicole Leigh Ksiazkiewicz, NURSE PRACTITIONER
• KTM Support Group, LLC
• Tina V. Kuba, A.P.R.N.
• Erika Charlotte Kube, M.D.
• Tracey L Kubik

• Clinical Social Worker in Columbus, OH
• Providers in Columbus, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2017; 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.