Carrie A. Kozak-Hietala, LISW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

I.2405256 Issued in OH

Practice address

2115 West Park Drive
Lorain, OH 44053-1138

Phone

(440) 989-4900

Fax

(440) 282-4779

NPI assigned

May 31, 2017

Last updated

Apr 12, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

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

Specialty

Mental Health Counselor

Education

Other, 2008

Medicare assignment

May accept Medicare assignment

Group practices

Avenues of Counseling and MediationGroup PAC ID 6406931880, 27 clinicians

Practice addresses (Care Compare)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Avenues of Counseling and Mediation

  • Mental Health Counselor
  • Medina, OH
  • NPI 1225253107
  Medicare reassignment Care Compare group
• Women's Center of Greater Cleveland

  • Addiction (Substance Use Disorder) Counselor
  • Cleveland, OH
  • NPI 1063470888
  NPD (past)

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

{
    "created_epoch": "1496188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712880000000",
    "number": "1922536283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2115 WEST PARK DRIVE",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "440531138",
            "telephone_number": "440-989-4900",
            "fax_number": "440-282-4779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2115 WEST PARK DRIVE",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "440531138",
            "telephone_number": "440-989-4900",
            "fax_number": "440-282-4779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOZAK-HIETALA",
        "first_name": "CARRIE",
        "middle_name": "A.",
        "name_prefix": "Mrs.",
        "credential": "LISW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-31",
        "last_updated": "2024-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S0800557",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "I.2405256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey J Kosiba, CDCA
• Celeste Kostelnik, DMD
• Manjula Kottapalli, MD
• Amy Lynn Koutsopoulos
• Lawrence M Kovalcik, PA-C
• Catherine Koziarz
• Delora Ann Kozusko, RN
• Kathleen M. Kraska, RN
• Edward Krause, LSW
• Robin Vee Krause, CNS, CNP

• Social Worker in Lorain, OH
• Providers in Lorain, OH by specialty
• Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 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.