Individual provider Active NPI

Grace Korzekwa, LCSW

  • Clinical Social Worker
  • Memphis, TN
National Provider Identifier
1861707135
Registry record updated Jan 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
5739 Issued in TN
Practice address
2150 Whitney Ave
Comprehensive Counseling Network
Memphis, TN 38127-6662
Phone
(901) 354-7391
Fax
(901) 354-7390
NPI assigned
Aug 11, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 7, 2013

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 5739 TN Primary

Addresses

Primary practice location

2150 Whitney Ave
Comprehensive Counseling Network
Memphis, TN 38127-6662

Mailing address

2150 Whitney Ave
Memphis, TN 38127-6662
Phone (901) 354-7391

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

LicenseStateTypeSpecialty
5739TNMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1281484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357516800000",
    "number": "1861707135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2150 WHITNEY AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381276662",
            "telephone_number": "901-354-7391",
            "fax_number": "901-354-7390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 WHITNEY AVE",
            "address_2": "COMPREHENSIVE COUNSELING NETWORK",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381276662",
            "telephone_number": "901-354-7391",
            "fax_number": "901-354-7390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORZEKWA",
        "first_name": "GRACE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-11",
        "last_updated": "2013-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "5739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2013; 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.