Individual provider Active NPI

Stephen Kozak, MSW, LICSW

  • Clinical Social Worker
  • North Easton, MA
National Provider Identifier
1770068249
Registry record updated Oct 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
114132 Issued in MA
Practice address
141 Sheridan St
North Easton, MA 02356-1913
Phone
(781) 956-1548
NPI assigned
Oct 1, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2018

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 114132 MA Primary

Addresses

Primary practice location

141 Sheridan St
North Easton, MA 02356-1913

Mailing address

141 Sheridan St
North Easton, MA 02356-1913
Phone (781) 956-1548

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
114132MAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1538352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538352000000",
    "number": "1770068249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 SHERIDAN ST",
            "city": "NORTH EASTON",
            "state": "MA",
            "postal_code": "023561913",
            "telephone_number": "781-956-1548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 SHERIDAN ST",
            "city": "NORTH EASTON",
            "state": "MA",
            "postal_code": "023561913",
            "telephone_number": "781-956-1548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOZAK",
        "first_name": "STEPHEN",
        "credential": "MSW, LICSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-10-01",
        "last_updated": "2018-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "114132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Easton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2018; 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.