Edward Leo Mislak, MSW LCSWC CACAD

Primary specialty

Social WorkerTaxonomy code 104100000X

License

08156 Issued in MD

Practice address

801 Chance CT
Street, MD 21154-1648

Phone

(410) 893-7217

Fax

(410) 893-7217

NPI assigned

Jan 30, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Harford County Counseling Services, LLC.

  • Community/Behavioral Health Agency
  • Street, MD
  • NPI 1336475524
  NPD (past)

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514332800000",
    "number": "1922144203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 CHANCE COURT",
            "city": "STREET",
            "state": "MD",
            "postal_code": "21154",
            "telephone_number": "410-893-7217",
            "fax_number": "410-893-7217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 CHANCE CT",
            "city": "STREET",
            "state": "MD",
            "postal_code": "211541648",
            "telephone_number": "410-893-7217",
            "fax_number": "410-893-7217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISLAK",
        "first_name": "EDWARD",
        "middle_name": "LEO",
        "name_prefix": "Mr.",
        "credential": "MSW LCSWC CACAD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2017-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MD",
            "license": "AC1003",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MD",
            "license": "08156",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "031101400",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "137882",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Beth Creighton, M.S., O.T./L
• Edward L. Mislak, LLC
• Rachael Lynn Guzman
• Harford County Counseling Services, LLC.
• Peter Johnson, AA-C, PA-C
• Shana Janine Mislak, MSW LCSW C CCDC
• Dana Lynn Reaves, LCSW-C
• Susan Jean Ruckel, MSW, LCSW-C
• Dianne K Sellers, LDEM, CPM, CBE,

• Social Worker in Street, MD
• Providers in Street, MD by specialty
• Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2017; 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.