Debra Lyne Bujalka, PHD, LCSW, PEL

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.011249 Issued in IL

Practice address

1714 65TH PL
Indian Head Park, IL 60525-4563

Phone

(708) 932-3435

NPI assigned

Aug 10, 2024

Last updated

Aug 10, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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 IL

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

Specialty

Clinical Social Worker

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Silver Rising Therapy LLCGroup PAC ID 8729584305, 24 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Silver Rising Therapy LLC

  • Clinical Social Worker
  • Burr Ridge, IL
  • NPI 1659254068
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1723248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723248000000",
    "number": "1902637036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1714 65TH PL",
            "city": "INDIAN HEAD PARK",
            "state": "IL",
            "postal_code": "605254563",
            "telephone_number": "708-932-3435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1714 65TH PL",
            "city": "INDIAN HEAD PARK",
            "state": "IL",
            "postal_code": "605254563",
            "telephone_number": "708-932-3435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUJALKA",
        "first_name": "DEBRA",
        "middle_name": "LYNE",
        "name_prefix": "Dr.",
        "credential": "PHD, LCSW, PEL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-10",
        "last_updated": "2024-08-10",
        "certification_date": "2024-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.011249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Luis Archundia, LCSW
• Carolyn Brennan
• Briar Place Nursing, LLC
• Briar Place, LTD. (Briar Place)
• Lea Brown, OTR/L
• Carolyn Renee Bulmash, L.C.S.W.
• Deborah L Buscemi, LCSW
• Mike Cvetkovic, D.D.S.
• Tiberiu Fulop, LAC
• Judith H Green, LCPC

• Clinical Social Worker in Indian Head Park, IL
• Providers in Indian Head Park, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.