Individual provider Active NPI

Mary A. Kusz, CSAC

  • Addiction (Substance Use Disorder) Counselor
  • Milwaukee, WI
National Provider Identifier
1639581234
Registry record updated Apr 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
15949-132 Issued in WI
Practice address
10045 W Lisbon Ave
5757 W. Oklahoma Ave.
Milwaukee, WI 53222-2446
Phone
(414) 358-7999
NPI assigned
May 30, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 15865-131 WI
Addiction (Substance Use Disorder) Counselor 101YA0400X 15949-132 WI Primary

Addresses

Primary practice location

10045 W Lisbon Ave
5757 W. Oklahoma Ave.
Milwaukee, WI 53222-2446

Mailing address

10045 W Lisbon Ave
5757 West Oklahoma Avenue, #201
Milwaukee, WI 53222-2446
Phone (414) 358-7144

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
15865-131WIMDAddiction (Substance Use Disorder) Counselor
15949-132WIMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1401408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459728000000",
    "number": "1639581234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10045 W LISBON AVE",
            "address_2": "5757 WEST OKLAHOMA AVENUE, #201",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532222446",
            "telephone_number": "414-358-7144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10045 W LISBON AVE",
            "address_2": "5757 W. OKLAHOMA AVE.",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532222446",
            "telephone_number": "414-358-7999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUSZ",
        "first_name": "MARY",
        "middle_name": "A.",
        "name_prefix": "Mrs.",
        "credential": "CSAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-30",
        "last_updated": "2016-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "15865-131",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "15949-132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2016; 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.