Organization Active NPI

Nell Kushlak, LCSW PLLC

  • Community/Behavioral Health Agency
  • Winchester, VA
National Provider Identifier
1689140915
Registry record updated Oct 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
NELL KUSHLAK, LCSW PLLC
Practice address
124 Amherst St Ste 203
Winchester, VA 22601-4114
Phone
(540) 242-1415
Fax
(540) 242-1371
NPI assigned
Oct 14, 2018
Last updated
Oct 14, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2018

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

Authorized official

Name
Nell B Kushlak, LCSWNPI 1619038718
Title
Member Manager
Phone
(540) 242-1415

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

124 Amherst St Ste 203
Winchester, VA 22601-4114

Mailing address

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

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181126002987 VA Part B Supplier - Clinic/Group Practice 4587918834 Receives reassigned benefits from 1 practitioner
Practice locations: Winchester, VA

National Provider Directory

National Provider Directory

Locations

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1539475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539475200000",
    "number": "1689140915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "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"
        },
        {
            "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": [],
    "basic": {
        "organization_name": "NELL KUSHLAK, LCSW PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-14",
        "last_updated": "2018-10-14",
        "status": "A",
        "authorized_official_last_name": "KUSHLAK",
        "authorized_official_first_name": "NELL",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "MEMBER MANAGER",
        "authorized_official_telephone_number": "540-242-1415",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winchester, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.