Individual provider Active NPI

Alicja Wioletta Kusiak-Brownstein, PH.D., MSW

  • Clinical Social Worker
  • Valparaiso, IN
National Provider Identifier
1477123503
Registry record updated Jun 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
2005 Valparaiso St Ste 209
Valparaiso, IN 46383-3331
Phone
(219) 252-5464
Fax
(219) 728-1869
NPI assigned
Jun 30, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

2005 Valparaiso St Ste 209
Valparaiso, IN 46383-3331

Mailing address

17801 Waxwing LN
South Bend, IN 46635-1328
Phone (574) 401-3928

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)
Not enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Lpa Co. Clinical CurrentSince Jul 4, 2021 Accepting new patients

Locations

2005 Valparaiso St
Ste 209
Valparaiso, IN 46383
Phone (219) 252-5464

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1625011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625011200000",
    "number": "1477123503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17801 WAXWING LN",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466351328",
            "telephone_number": "574-401-3928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2005 VALPARAISO ST STE 209",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463833331",
            "telephone_number": "219-252-5464",
            "fax_number": "219-728-1869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUSIAK-BROWNSTEIN",
        "first_name": "ALICJA",
        "middle_name": "WIOLETTA",
        "name_prefix": "Dr.",
        "credential": "PH.D., MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-30",
        "last_updated": "2021-06-30",
        "certification_date": "2021-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valparaiso, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2021; 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.