Mr Frederick Elias Persiko, M DIV, CACITI is a
Social Worker based in Basalt, Colorado. Mr Frederick Elias Persiko is licensed to practice in Michigan (license number 6807010854) and his current practice location is
23400 Two Rivers Road, #49, Basalt, Colorado. He can be reached at his office (for appointments etc.) via phone at
(970) 927-5357.
NPI number for Mr Frederick Elias Persiko is 1730320557 and his current mailing address is P.o. Box 138, Basalt, Colorado. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1730320557.
Healthcare Provider's Profile
| Full Name | Mr Frederick Elias Persiko |
|---|
| Gender | Male |
|---|
| Speciality | Social Worker |
|---|
| Location | 23400 Two Rivers Road, Basalt, Colorado |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1730320557
- Provider Enumeration Date: 03/09/2009
- Last Update Date: 03/09/2009
Medical Identifiers
Medical identifiers for Mr Frederick Elias Persiko such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1730320557 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 2810 (Colorado) | Secondary |
| 104100000X | Social Worker | 6807010854 (Michigan) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Frederick Elias Persiko is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mr Frederick Elias Persiko, M DIV, CACITI
P.o. Box 138,
Basalt, CO 81621
Ph: (970) 927-5357 | Mr Frederick Elias Persiko, M DIV, CACITI
23400 Two Rivers Road, #49,
Basalt, CO 81621
Ph: (970) 927-5357 |
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