Active NPI
Kevin A. Komosa, LCSW
- Social Worker
- Gary, IN
National Provider Identifier
1841490901
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 34002375A
- Practice address
- 8221 Oak Ave
Gary, IN 46403-1477 - Phone
- (219) 938-9482
- NPI assigned
- Jul 18, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 34002375A | IN | Primary |
Addresses
Primary practice location
8221 Oak Ave
Gary, IN 46403-1477
Mailing address
8221 Oak Ave
Gary, IN 46403-1477
Phone (219) 938-9482
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34002375A | IN | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Green House and Associates Inc | Past | Accepting new patients |
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.
-
- Psychologist
- McCordsville, IN
- NPI 1558316463
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184716800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1231372800000",
"number": "1841490901",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8221 OAK AVE",
"city": "GARY",
"state": "IN",
"postal_code": "464031477",
"telephone_number": "219-938-9482"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8221 OAK AVE",
"city": "GARY",
"state": "IN",
"postal_code": "464031477",
"telephone_number": "219-938-9482"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOMOSA",
"first_name": "KEVIN",
"middle_name": "A.",
"name_prefix": "Mr.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-07-18",
"last_updated": "2009-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "IN",
"license": "34002375A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gary, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.