| Jackie Gasparovic Corp. | |
|
2804 Boilermaker Ct Ste A Valparaiso IN 46383-8418 | |
| (219) 286-7258 | |
| (219) 286-7262 |
| Full Name | Jackie Gasparovic Corp. |
|---|---|
| Speciality | Social Worker |
| Location | 2804 Boilermaker Ct Ste A, Valparaiso, Indiana |
| Authorized Official Name and Position | Jacqueline Gasparovic (OWNER) |
| Authorized Official Contact | 2192867258 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jackie Gasparovic Corp. 2804 Boilermaker Ct Ste A Valparaiso IN 46383-8418 Ph: (219) 286-7258 | Jackie Gasparovic Corp. 2804 Boilermaker Ct Ste A Valparaiso IN 46383-8418 Ph: (219) 286-7258 |
| NPI Number | 1427547744 |
|---|---|
| Provider Enumeration Date | 05/02/2018 |
| Last Update Date | 05/02/2018 |
| Medicare PECOS PAC ID | 2264785963 |
|---|---|
| Medicare Enrollment ID | O20181026000435 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427547744 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 34006222A (Indiana) | Primary |
| Provider Name | Jacqueline M Gasparovic |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962538744 PECOS PAC ID: 3375777121 Enrollment ID: I20131009001748 |
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