Individual provider Active NPI

Marta Anna Kulikowska-Minnich, LCSW

  • Mental Health Counselor
  • Leominster, MA
National Provider Identifier
1982992749
Registry record updated Jul 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
217205 Issued in MA
Practice address
45 Summer St
Leominster, MA 01453-3228
Phone
(508) 373-7824
NPI assigned
Jul 14, 2011
Last updated
Jul 14, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 217205 MA Primary

Addresses

Primary practice location

45 Summer St
Leominster, MA 01453-3228

Mailing address

45 Summer St
Leominster, MA 01453-3228

Other identifiers 1

IdentifierTypeStateIssuer
1303007MedicaidMA

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20131126000536 MA Practitioner - Clinical Social Worker 5395971113 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

72 Jaques Ave
Worcester, MA 01610-2480

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
217205MAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Community Healthlink, Inc. CurrentSince Sep 1, 2013 Accepting new patients
Community Healthlink Inc CurrentSince Sep 1, 2013 Accepting new patients
Counseling Center at Millbury LLC CurrentSince May 6, 2024 Accepting new patients

Locations

2328 10th Ave N
Ste 302
Lake Worth Beach, FL 33461
Phone (561) 318-4411

40 Spruce St
Leominster, MA 01453
Phone (978) 466-3820

40 Spruce St
#2
Leominster, MA 01453
Phone (978) 534-6116

29 Main St
Ste 100
Millbury, MA 01527
Phone (508) 433-3866

72 Jaques Ave
Worcester, MA 01610
Phone (508) 860-1154

Organizations & group practices 3

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": "1310601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310601600000",
    "number": "1982992749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 SUMMER ST",
            "city": "LEOMINSTER",
            "state": "MA",
            "postal_code": "014533228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 SUMMER ST",
            "city": "LEOMINSTER",
            "state": "MA",
            "postal_code": "014533228",
            "telephone_number": "508-373-7824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KULIKOWSKA-MINNICH",
        "first_name": "MARTA",
        "middle_name": "ANNA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-14",
        "last_updated": "2011-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "217205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1303007",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leominster, MA

Sources for this page

Verify at the official NPI Registry.