Mark J Niezgoda, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW60991792 Issued in WA

Practice address

4219 S Othello St Apt 517
Seattle, WA 98118-3886

Phone

(206) 321-3997

NPI assigned

Mar 30, 2020

Last updated

Mar 30, 2020By the provider in NPPES

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

Enrolled in WA

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

Specialty

Clinical Social Worker

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Renton Counseling Center PLLCGroup PAC ID 6901340298, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Renton Counseling Center, PLLC

  dba Vera Dragonchuk

  • Mental Health Counselor
  • Renton, WA
  • NPI 1144735911
  Medicare reassignment Care Compare group NPD
• Marks Health

  • Clinical Social Worker
  • Seattle, WA
  • NPI 1174141915
  NPD Authorized official

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

{
    "created_epoch": "1585526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585526400000",
    "number": "1447888946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4219 S OTHELLO ST APT 517",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981183886",
            "telephone_number": "206-321-3997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4219 S OTHELLO ST APT 517",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981183886",
            "telephone_number": "206-321-3997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEZGODA",
        "first_name": "MARK",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-03-30",
        "last_updated": "2020-03-30",
        "certification_date": "2020-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW60991792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emma Diane Nierman, LICSW
• Lauren Elise Niernberg, ARNP
• Katelyn Elizabeth Nies, LMHC
• Stefanie Niesz
• Sophia Laraine Nieto
• Nigel W. Saw, DDS, PC (Family Dentistry)
• Nigel W. Saw, DDS, PC
• Theresa A. Night, PT
• Nightingale Homecare LLC
• Nightingale Medical Billing

• Clinical Social Worker in Seattle, WA
• Providers in Seattle, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.