Elizabeth Prostak, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

126846 Issued in MA

Practice address

20 Meadowbrook Rd
Brockton, MA 02301-7122

Phone

(508) 580-0801

NPI assigned

Nov 30, 2016

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 MA

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.

• Brockton Hospital, Inc.

  • General Acute Care Hospital
  • Brockton, MA
  • NPI 1063431286
  Medicare reassignment NPD
• Community Counseling of Bristol County, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Taunton, MA
  • NPI 1730215781
  Medicare reassignment NPD
• Signature Healthcare Medical Group Inc

  • Internal Medicine Physician
  • Brockton, MA
  • NPI 1508804949

  Social Worker

  Medicare reassignment NPD
• Brockton Hospital, Inc.

  • Community/Retail Pharmacy
  • East Bridgewater, MA
  • NPI 1033084462
  NPD
• Community Counseling of Bristol County Inc

  • Home Health Agency
  • Taunton, MA
  • NPI 1659791515
  NPD

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

{
    "created_epoch": "1480464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735516800000",
    "number": "1982147526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 FORDHAM RD",
            "city": "ALLSTON",
            "state": "MA",
            "postal_code": "021343000",
            "telephone_number": "617-782-6469",
            "fax_number": "781-848-0206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 MEADOWBROOK RD",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023017122",
            "telephone_number": "508-580-0801"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14 Fordham Rd",
            "address_purpose": "LOCATION",
            "city": "Allston",
            "state": "MA",
            "postal_code": "021343000",
            "country_code": "US",
            "telephone_number": "617-782-6460 x213",
            "fax_number": "781-848-0206",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "680 Centre St",
            "address_purpose": "LOCATION",
            "city": "Brockton",
            "state": "MA",
            "postal_code": "023023308",
            "country_code": "US",
            "telephone_number": "508-941-7150",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PROSTAK",
        "first_name": "ELIZABETH",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-30",
        "last_updated": "2024-12-30",
        "certification_date": "2024-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MA",
            "license": "000226675",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "126846",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dianna Marie Prisbrey
• Daniela Prodanovic, M.D.
• Progress Rehabilitation, Inc.
• Project Transformation Inc
• Pronurse Incorporated
• Karlyne Prou
• Eric Pruyne, LICSW
• Deborah Pryor-Moore, LICSW
• Jordyn Pugsley
• Shanice Pullen

• Clinical Social Worker in Brockton, MA
• Providers in Brockton, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.