Individual provider Active NPI

Marybelle Krzyzkowski

  • Clinical Social Worker
  • Leesburg, VA
National Provider Identifier
1558610923
Registry record updated Aug 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904001969 Issued in VA
Practice address
14350 Scherazade PL
Leesburg, VA 20176-5295
Phone
(703) 443-0458
NPI assigned
Aug 31, 2012
Last updated
Aug 31, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2012

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 0904001969 VA Primary

Addresses

Primary practice location

14350 Scherazade PL
Leesburg, VA 20176-5295

Mailing address

14350 Scherazade PL
Leesburg, VA 20176-5295

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0904001969VAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1346371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346371200000",
    "number": "1558610923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14350 SCHERAZADE PL",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201765295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14350 SCHERAZADE PL",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201765295",
            "telephone_number": "703-443-0458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRZYZKOWSKI",
        "first_name": "MARYBELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-31",
        "last_updated": "2012-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904001969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, VA

Sources for this page

Verify at the official NPI Registry.