| Living Waters Lcsw Pc | |
|
29 Northgate Dr Greenlawn NY 11740-2312 | |
| (631) 271-0913 | |
| (631) 261-3250 |
| Full Name | Living Waters Lcsw Pc |
|---|---|
| Speciality | Social Worker |
| Location | 29 Northgate Dr, Greenlawn, New York |
| Authorized Official Name and Position | Carol Rubano (PRESIDENT) |
| Authorized Official Contact | 6317543990 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Living Waters Lcsw Pc 29 Northgate Dr Greenlawn NY 11740-2312 Ph: (631) 271-0913 | Living Waters Lcsw Pc 29 Northgate Dr Greenlawn NY 11740-2312 Ph: (631) 271-0913 |
| NPI Number | 1780856062 |
|---|---|
| Provider Enumeration Date | 03/27/2008 |
| Last Update Date | 02/29/2024 |
| Certification Date | 02/29/2024 |
| Medicare PECOS PAC ID | 7719032606 |
|---|---|
| Medicare Enrollment ID | O20090828000023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780856062 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Carol Rubano |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942300538 PECOS PAC ID: 4082769971 Enrollment ID: I20090828000019 |
| Provider Name | Robert P Clock |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164630059 PECOS PAC ID: 3870649841 Enrollment ID: I20090916000033 |
| Provider Name | Patricia A King |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831308568 PECOS PAC ID: 5294905576 Enrollment ID: I20110921000163 |
| Provider Name | Janice Driscoll |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306112412 PECOS PAC ID: 1557525052 Enrollment ID: I20120613000537 |
| Provider Name | Irene P Korolczuk |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104963982 PECOS PAC ID: 4587891148 Enrollment ID: I20131206000081 |
| Provider Name | Madeline Queck |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316097637 PECOS PAC ID: 4183055718 Enrollment ID: I20200514000485 |
| Provider Name | Gregory Muhs |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932570124 PECOS PAC ID: 8123449188 Enrollment ID: I20200528002947 |
| Provider Name | Margo Messina |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467678326 PECOS PAC ID: 0749648921 Enrollment ID: I20230620002775 |
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