Individual provider Active NPI

Nell B Kushlak, LCSW

  • Clinical Social Worker
  • Winchester, VA
National Provider Identifier
1619038718
Registry record updated Nov 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904009233 Issued in VA
Practice address
124 Amherst St Ste 203
Winchester, VA 22601-4114
Phone
(540) 242-1415
Fax
(540) 242-1371
NPI assigned
Dec 12, 2006
Last updated
Nov 19, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2018

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 0904009233 VA Primary

Addresses

Primary practice location

124 Amherst St Ste 203
Winchester, VA 22601-4114

Mailing address

124 Amherst St
Winchester, VA 22601-4114
Phone (540) 242-1415

Other practice location 1

125 S Cameron St
Winchester, VA 22601-4732
Phone (540) 722-0750

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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

Enrollment IDStateProvider typePAC IDDetails
I20160317000974 VA Practitioner - Clinical Social Worker 4789672767 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

124 Amherst St
Suite 203
Winchester, VA 22601-4114
Phone (540) 242-1415

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0904009233VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Nell Kushlak, LCSW PLLC CurrentSince Oct 12, 2018 Accepting new patients
Roxanne Ostlund LPC PLCC PastSince Feb 27, 2016 Accepting new patients
Maine Center, Inc. Past Accepting new patients

Locations

124 Amherst St
Ste 203
Winchester, VA 22601
Phone (540) 242-1415

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542585600000",
    "number": "1619038718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 AMHERST ST",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226014114",
            "telephone_number": "540-242-1415",
            "fax_number": "540-242-1371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 AMHERST ST STE 203",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226014114",
            "telephone_number": "540-242-1415",
            "fax_number": "540-242-1371"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "125 S CAMERON ST",
            "address_purpose": "LOCATION",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226014732",
            "country_code": "US",
            "telephone_number": "540-722-0750",
            "fax_number": "540-722-0751",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUSHLAK",
        "first_name": "NELL",
        "middle_name": "B",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-12",
        "last_updated": "2018-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904009233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winchester, VA

Sources for this page

Verify at the official NPI Registry.