NICOLE BORUSIEWICZ (LCSW,LMSW,MSW,BSW) – Clinical Social Worker, NPI 1043647373

NICOLE BORUSIEWICZ (LCSW,LMSW,MSW,BSW) is a healthcare provider. based in Waterbury, Connecticut. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LCSW,LMSW,MSW,BSW. They hold a License No. 000826 (CT). The NPI Number for NICOLE BORUSIEWICZ (LCSW,LMSW,MSW,BSW) is 1043647373

Main info

Female
12 Years Of Experience
Accepts Medicare Assignment
Name
NICOLE BORUSIEWICZ (LCSW,LMSW,MSW,BSW)
NPI
1043647373
Phone
(203) 574-9000
Address
141 E MAIN ST
Enumeration Date
1 October 2013
Last Update Date
26 March 2025

Doctor Profile

Medical School Name
FORDHAM UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
2037551143
Graduation Year
2014 (12 years ago)
PAC ID
5597028761
Group Practice PAC ID
6305750480
Professional Enrollment ID
I20180423000554
Address ID
CT067021701WA402XXSTXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience57
Completeness75
Years active:12State licenses:2Digital endpointsOther names

2,153 CLINICAL SOCIAL WORKER in CT

Provider Addresses for NICOLE BORUSIEWICZ (LCSW,LMSW,MSW,BSW)

  • 141 E MAIN ST

    3RD FLOOR-HOME BASED SERVICES

    WATERBURY, CT 067022310

    Phone: (203) 574-9000

    Fax: (203) 574-9006

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2018-04-23

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20180423000554IClinical Social WorkerCTTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 06702)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6305750480View full group profile
NameSpecialtyState
P O D I A T R YKS
Nurse PractitionerCT
Certified Nurse Midwife (Cnm)CT
-CT
P S Y C H I A T R YCT
-CO
Nurse PractitionerCT
Clinical Social WorkerCT
Registered Dietitian Or Nutrition ProfessionalCT
Geriatric MedicineMA

Reviews

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Frequently asked questions

What NPI should I save for NICOLE BORUSIEWICZ (LCSW,LMSW,MSW,BSW)?
Save NPI 1043647373 if you need a stable reference for NICOLE BORUSIEWICZ (LCSW,LMSW,MSW,BSW).
Is NICOLE BORUSIEWICZ (LCSW,LMSW,MSW,BSW) currently active in the NPI registry?
CMS-published data lists NICOLE BORUSIEWICZ (LCSW,LMSW,MSW,BSW) as an active registrant.
What kind of provider is NICOLE BORUSIEWICZ (LCSW,LMSW,MSW,BSW)?
The page reflects Clinical Social Worker for NICOLE BORUSIEWICZ (LCSW,LMSW,MSW,BSW). Clinical services aligned with this taxonomy classification.
Where is NICOLE BORUSIEWICZ (LCSW,LMSW,MSW,BSW)'s primary listing?
We display Waterbury, Connecticut because that is what the record indicates for NICOLE BORUSIEWICZ (LCSW,LMSW,MSW,BSW).
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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