Individual provider Active NPI

Tanya Czarnecki, APSW

  • Clinical Social Worker
  • Milwaukee, WI
National Provider Identifier
1669898110
Registry record updated Mar 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1291888-121 Issued in WI
Practice address
1300 N Jackson St
Milwaukee, WI 53202-2602
Phone
(414) 390-5800
Fax
(414) 390-5808
NPI assigned
Mar 7, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2014

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 1291888-121 WI Primary

Addresses

Primary practice location

1300 N Jackson St
Milwaukee, WI 53202-2602

Mailing address

1300 N Jackson St
Milwaukee, WI 53202-2602
Phone (414) 390-5800

Other identifiers 1

IdentifierTypeStateIssuer
129188-121OtherWIWI LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20161214001328 WI Practitioner - Clinical Social Worker 1153601869 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Jewish Family Services, Inc.Group PAC ID 6608828819, 8 clinicians

Practice addresses (Care Compare)

1300 N Jackson St
Milwaukee, WI 53202-2602
Phone (414) 390-5800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1291888-121WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Jewish Family Services, Inc. CurrentSince Oct 23, 2017 Accepting new patients

Locations

1300 N Jackson St
Milwaukee, WI 53202
Phone (414) 390-5800

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": "1394150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394150400000",
    "number": "1669898110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 N JACKSON ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532022602",
            "telephone_number": "414-390-5800",
            "fax_number": "414-390-5808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 N JACKSON ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532022602",
            "telephone_number": "414-390-5800",
            "fax_number": "414-390-5808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CZARNECKI",
        "first_name": "TANYA",
        "credential": "APSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-07",
        "last_updated": "2014-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "1291888-121",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WI LICENSE",
            "identifier": "129188-121",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.