Jennie C Kozlik

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I.1800821-SUPV Issued in OH

Practice address

7232 Justin Way
Mentor, OH 44060-4881

Phone

(440) 578-8200

NPI assigned

Jan 20, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Signature Health, Inc.

  • Mental Health Counselor
  • Garfield Heights, OH
  • NPI 1679767289
  Medicare reassignment NPD
• Signature Health Inc

  • Long Term Care Pharmacy
  • Willoughby, OH
  • NPI 1740502335
  NPD
• Signature Health, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Willoughby, OH
  • NPI 1477575348
  NPD

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

{
    "created_epoch": "1642636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677542400000",
    "number": "1902558059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7232 JUSTIN WAY",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440604881",
            "telephone_number": "440-578-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7232 JUSTIN WAY",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440604881",
            "telephone_number": "440-578-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOZLIK",
        "first_name": "JENNIE",
        "middle_name": "C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-20",
        "last_updated": "2023-02-28",
        "certification_date": "2023-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1800821-SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chris Koval
• Audrey Kovalak, RN
• Jennifer Kovell
• Courtney Kathleen Kozek, PA-C
• Mary C Kozina, LISW-S
• Tamara Ann Kraft
• Tara Krall, OTR/L
• Michelle Kramer
• Samantha J Kramer, LPC
• Stacy Marie Kramer, LPCC

• Clinical Social Worker in Mentor, OH
• Providers in Mentor, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.