Kirk D Fasshauer, LCSW | |
1255 Golfview Ave, Bartow, FL 33830-6736 | |
(863) 519-0575 | |
Not Available |
Full Name | Kirk D Fasshauer |
---|---|
Gender | Male |
Speciality | Social Worker - Clinical |
Location | 1255 Golfview Ave, Bartow, Florida |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1538240346 | NPI | - | NPPES |
761955300 | Medicaid | FL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | SW15228 (Florida) | Primary |
Entity Name | Peace River Center For Personal Development Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1821097767 PECOS PAC ID: 7719877927 Enrollment ID: O20040319000056 |
Mailing Address | Practice Location Address |
---|---|
Kirk D Fasshauer, LCSW Po Box 1559, Bartow, FL 33831-1559 Ph: (863) 519-0575 | Kirk D Fasshauer, LCSW 1255 Golfview Ave, Bartow, FL 33830-6736 Ph: (863) 519-0575 |
Cynthia Roberts, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1239 E Main St, Bartow, FL 33830 Phone: 863-519-0575 | |
Sabrina Gonzalez, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1239 E Main St, Bartow, FL 33830 Phone: 863-519-0575 Fax: 863-582-9251 | |
Miss Angela M Jones, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1239 E Main St, Bartow, FL 33830 Phone: 863-519-0575 Fax: 863-582-9251 | |
Rosalind M Deangelis-tyre, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2155 Golden Meadow Way, Bartow, FL 33830 Phone: 386-397-4972 | |
Carla Bordin, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 113 E Main St, Bartow, FL 33830 Phone: 813-689-8828 Fax: 813-689-8802 | |
Karen Barber Stewart, LCSW, CAP Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 1255 Golfview Ave, Bartow, FL 33830 Phone: 863-519-0575 Fax: 863-582-9251 |