Mr Seweryn W Borecki, LCSW | |
731c Bridgeport Ave, Shelton, CT 06484-4704 | |
(203) 200-0792 | |
Not Available |
Full Name | Mr Seweryn W Borecki |
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Gender | Male |
Speciality | Social Worker - Clinical |
Location | 731c Bridgeport Ave, Shelton, Connecticut |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1730376369 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | 7730 (Connecticut) | Primary |
1041C0700X | Social Worker - Clinical | SW10640 (Florida) | Secondary |
Entity Name | State Of Connecticut |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1487689022 PECOS PAC ID: 8022915677 Enrollment ID: O20040319000169 |
Mailing Address | Practice Location Address |
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Mr Seweryn W Borecki, LCSW 731c Bridgeport Ave, Shelton, CT 06484-4704 Ph: () - | Mr Seweryn W Borecki, LCSW 731c Bridgeport Ave, Shelton, CT 06484-4704 Ph: (203) 200-0792 |
Kelly Dougherty, LMSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2 Trap Falls Rd Ste 120, Shelton, CT 06484 Phone: 203-816-6424 Fax: 203-513-8474 | |
Sandra Dickens, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1 Enterprise Dr Ste 415, Shelton, CT 06484 Phone: 203-255-5078 | |
Christine Zangrillo, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 1000 Bridgeport Ave Ste 202, Shelton, CT 06484 Phone: 203-712-9998 Fax: 203-242-1165 | |
Mr. Kenneth Michael Lacilla, MSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 476 Howe Ave, Suite 4, Shelton, CT 06484 Phone: 203-924-9426 | |
Cori Testani, MSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2 Trap Falls Rd, Shelton, CT 06484 Phone: 203-816-6424 | |
Tracy Clough, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 515 Bridgeport Ave, Shelton, CT 06484 Phone: 973-809-4722 | |
Jennifer Dawn Guarino, Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 476 Howe Ave Ste 4, Shelton, CT 06484 Phone: 203-924-9426 |