Active NPI
Mary E Zdroik, CSAC
- Addiction (Substance Use Disorder) Counselor
- Milwaukee, WI
National Provider Identifier
1992043772
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 11450-132
- Practice address
- 1225 W Mitchell St
#223
Milwaukee, WI 53204-3383 - Phone
- (414) 383-4455
- Fax
- (414) 727-8730
- NPI assigned
- Jan 29, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 11450-132 | WI | Primary |
| Social Worker | 104100000X | 5314-120 | WI |
Addresses
Primary practice location
1225 W Mitchell St
#223
Milwaukee, WI 53204-3383
Mailing address
1225 W Mitchell St
#223
Milwaukee, WI 53204-3383
Phone (414) 383-4455
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5314-120 | Other | WI | LICENSE-SOCIAL WORKER |
| 11450-132 | Other | WI | LICENSE-CSAC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11450-132 | WI | MD | Addiction (Substance Use Disorder) Counselor |
| 5314-120 | WI | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1359417600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1359417600000",
"number": "1992043772",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1225 W MITCHELL ST",
"address_2": "#223",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532043383",
"telephone_number": "414-383-4455",
"fax_number": "414-727-8730"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1225 W MITCHELL ST",
"address_2": "#223",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532043383",
"telephone_number": "414-383-4455",
"fax_number": "414-727-8730"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZDROIK",
"first_name": "MARY",
"middle_name": "E",
"name_prefix": "Miss",
"credential": "CSAC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-01-29",
"last_updated": "2013-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "WI",
"license": "11450-132",
"primary": true
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "WI",
"license": "5314-120",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE-SOCIAL WORKER",
"identifier": "5314-120",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE-CSAC",
"identifier": "11450-132",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Milwaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.