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NPI Code Detail

MEDICARE: DR. ALICJA WIOLETTA KUSIAK-BROWNSTEIN PH.D., MSW

MEDICARE: DR. ALICJA WIOLETTA KUSIAK-BROWNSTEIN PH.D., MSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker

General Provider Information

NPI Number : 1477123503
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ALICJA WIOLETTA KUSIAK-BROWNSTEIN PH.D., MSW
Provider Business Mailing Address
First Line : 17801 WAXWING LN
Second Line :
City : SOUTH BEND
State : IN
Zip : 46635-1328
Country : US
Telephone Number : 574-401-3928
Fax Number :
Provider Business Practice Location Address
First Line : 2005 VALPARAISO ST STE 209
Second Line :
City : VALPARAISO
State : IN
Zip : 46383-3331
Country : US
Telephone Number : 219-252-5464
Fax Number : 219-728-1869
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2021
Last Update Date : 06/30/2021

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