Individual provider Active NPI

Amy Koziarski, LISW

  • Clinical Social Worker
  • Sylvania, OH
National Provider Identifier
1972828200
Registry record updated Mar 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I 1000016 Issued in OH
Practice address
5800 Monroe St Ste H2
Sylvania, OH 43560-2260
Phone
(419) 343-7737
Fax
(567) 249-0114
NPI assigned
Mar 30, 2010
Last updated
Mar 8, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 8, 2022

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 I 1000016 OH Primary

Addresses

Primary practice location

5800 Monroe St Ste H2
Sylvania, OH 43560-2260

Mailing address

5800 Monroe St Ste H2
Sylvania, OH 43560-2260
Phone (419) 343-7737

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20130801000904 OH Practitioner - Clinical Social Worker 8628219649 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Amy Koziarski Lisw LLCGroup PAC ID 2365683380, 10 clinicians

Practice addresses (Care Compare)

5800 Monroe St
Suite H2
Sylvania, OH 43560-2260
Phone (419) 343-7737

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I 1000016OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Amy Koziarski Lisw LLC Clinical CurrentSince Jul 1, 2013 Accepting new patients
Monica Jay, MSW, Lisw-S, LLC Clinical PastSince Jul 1, 2013 Accepting new patients

Locations

6588 Secor Rd
Ste 11
Lambertville, MI 48144
Phone (419) 724-1500

134 W South Boundary St
Ste Bb
Perrysburg, OH 43551

5800 Monroe St
Ste H2
Sylvania, OH 43560
Phone (419) 343-7737

4159 N Holland Sylvania Rd
Ste 203
Toledo, OH 43623
Phone (419) 535-1901

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1269907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646697600000",
    "number": "1972828200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5800 MONROE ST STE H2",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "435602260",
            "telephone_number": "419-343-7737",
            "fax_number": "567-249-0114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5800 MONROE ST STE H2",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "435602260",
            "telephone_number": "419-343-7737",
            "fax_number": "567-249-0114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOZIARSKI",
        "first_name": "AMY",
        "credential": "LISW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-30",
        "last_updated": "2022-03-08",
        "certification_date": "2022-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I 1000016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sylvania, OH

Sources for this page

Verify at the official NPI Registry.