| Nancy Guadagno Lcsw Csac Llc | |
|
6123 Green Bay Rd Ste 240 Kenosha WI 53142-2927 | |
| (262) 564-5305 | |
| (262) 564-5306 |
| Full Name | Nancy Guadagno Lcsw Csac Llc |
|---|---|
| Speciality | Social Worker |
| Location | 6123 Green Bay Rd Ste 240, Kenosha, Wisconsin |
| Authorized Official Name and Position | Nancy Guadagno (SOLE PROVIDER) |
| Authorized Official Contact | 2626527193 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Nancy Guadagno Lcsw Csac Llc 6123 Green Bay Rd Ste 240 Kenosha WI 53142-2927 Ph: (262) 564-5305 | Nancy Guadagno Lcsw Csac Llc 6123 Green Bay Rd Ste 240 Kenosha WI 53142-2927 Ph: (262) 564-5305 |
| NPI Number | 1245730019 |
|---|---|
| Provider Enumeration Date | 02/18/2018 |
| Last Update Date | 10/08/2019 |
| Medicare PECOS PAC ID | 0345505103 |
|---|---|
| Medicare Enrollment ID | O20180525000976 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245730019 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | (* (Not Available)) | Primary |
| Provider Name | Nancy Guadagno |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275959157 PECOS PAC ID: 0446474571 Enrollment ID: I20140611002278 |
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