Individual provider Active NPI

Shari A Brustoski, LISW

  • Clinical Social Worker
  • Akron, OH
National Provider Identifier
1629310750
Registry record updated Mar 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.0008763 Issued in OH
Practice address
640 W Market St
Akron, OH 44303-1413
Phone
(330) 762-5425
NPI assigned
Mar 27, 2013
Last updated
Mar 27, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2013

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 I.0008763 OH Primary

Addresses

Primary practice location

640 W Market St
Akron, OH 44303-1413

Mailing address

640 W Market St
Akron, OH 44303-1413
Phone (330) 762-5425

Other identifiers 1

IdentifierTypeStateIssuer
I.0008763OtherOHINDEPENDENT SOCIAL WORKER

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

State licenses

LicenseStateTypeSpecialty
I.0008763OHMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1364342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364342400000",
    "number": "1629310750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 W MARKET ST",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443031413",
            "telephone_number": "330-762-5425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 W MARKET ST",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443031413",
            "telephone_number": "330-762-5425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUSTOSKI",
        "first_name": "SHARI",
        "middle_name": "A",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-27",
        "last_updated": "2013-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.0008763",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENT SOCIAL WORKER",
            "identifier": "I.0008763",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Akron, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2013; 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.