Provider Demographics
NPI:1477123503
Name:KUSIAK-BROWNSTEIN, ALICJA WIOLETTA (PHD, MSW)
Entity Type:Individual
Prefix:DR
First Name:ALICJA
Middle Name:WIOLETTA
Last Name:KUSIAK-BROWNSTEIN
Suffix:
Gender:F
Credentials:PHD, MSW
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:17801 WAXWING LN
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46635-1328
Mailing Address - Country:US
Mailing Address - Phone:574-401-3928
Mailing Address - Fax:
Practice Address - Street 1:2005 VALPARAISO ST STE 209
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46383-3331
Practice Address - Country:US
Practice Address - Phone:219-252-5464
Practice Address - Fax:219-728-1869
Is Sole Proprietor?:No
Enumeration Date:2021-06-30
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical