MRS. ALICJA MATUSIAK LISW-S CNP NPI 1174757678

NPI Information

NPI: 1174757678
Provider Name: MRS. ALICJA MATUSIAK, LISW-S, CNP
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

PECOS Registration: Yes

Address:
3099 SULLIVANT AVE STE H
COLUMBUS, OH
ZIP 43204
Phone: (614) 371-2303
Get Directions

MRS. Alicja Matusiak, LISW-S, CNP is a psychiatric/mental health nurse practitioner in Columbus, OH with 10 years of experience. MRS. Alicja Matusiak, LISW-S, CNP NPI is 1174757678. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

3099 SULLIVANT AVE STE H
COLUMBUS, OH
ZIP 43204-895
Phone: (614) 371-2303
Fax: (800) 905-9950

The NPI 1174757678 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/12/2009 and was last updated on 2/10/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	APRN.CNP.16032	OHIO	Yes
2	1041C0700X	Social Worker	Clinical	0800345	OHIO	No
3	163WH0200X	Registered Nurse	Home Health	359101	OHIO	No
4	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	COA.16032-NP	OHIO	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0116587	MEDICAID	OHIO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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