Individual provider Active NPI

Daniela Bularzik, LCSW

  • Clinical Social Worker
  • Saint Louis, MO
National Provider Identifier
1619795564
Registry record updated Sep 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2024034601 Issued in MO
Practice address
4389 W Pine Blvd
Saint Louis, MO 63108-2205
Phone
(314) 645-6247
Fax
(314) 645-6249
NPI assigned
Sep 30, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2024

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 2024034601 MO Primary

Addresses

Primary practice location

4389 W Pine Blvd
Saint Louis, MO 63108-2205

Mailing address

4389 W Pine Blvd
Saint Louis, MO 63108-2205
Phone (314) 645-6247

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20241127004213 MO Practitioner - Clinical Social Worker 4981139995 Reassigns benefits to 1 organization
I20250613000969 IL Practitioner - Clinical Social Worker 4981139995 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Memory Care Home SolutionsGroup PAC ID 6608147418, 5 clinicians

Practice addresses (Care Compare)

4389 W Pine Blvd
Saint Louis, MO 63108-2205
Phone (314) 645-6247

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Memory Care Home Solutions Clinical CurrentSince Sep 7, 2024 Accepting new patients

Locations

4389 W Pine Blvd
Saint Louis, MO 63108
Phone (314) 645-6247

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": "1727654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1619795564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4389 W PINE BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631082205",
            "telephone_number": "314-645-6247",
            "fax_number": "314-645-6249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4389 W PINE BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631082205",
            "telephone_number": "314-645-6247",
            "fax_number": "314-645-6249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULARZIK",
        "first_name": "DANIELA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-30",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2024034601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.