| Nick Yackovich, Phd, S.c. | |
|
2800 Royal Ave Ste 202 Monona WI 53713-1518 | |
| (608) 471-4222 | |
| (608) 471-4222 |
| Full Name | Nick Yackovich, Phd, S.c. |
|---|---|
| Speciality | Clinic/Center |
| Location | 2800 Royal Ave Ste 202, Monona, Wisconsin |
| Authorized Official Name and Position | Nick S Yackovich (PRESIDENT) |
| Authorized Official Contact | 6082150600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Nick Yackovich, Phd, S.c. 2800 Royal Ave Ste 202 Monona WI 53713-1518 Ph: (608) 215-0600 | Nick Yackovich, Phd, S.c. 2800 Royal Ave Ste 202 Monona WI 53713-1518 Ph: (608) 471-4222 |
| NPI Number | 1982326369 |
|---|---|
| Provider Enumeration Date | 09/13/2022 |
| Last Update Date | 10/30/2023 |
| Certification Date | 10/30/2023 |
| Medicare PECOS PAC ID | 8224484118 |
|---|---|
| Medicare Enrollment ID | O20231030000586 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982326369 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Nick S Yackovich |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1497909733 PECOS PAC ID: 2567766629 Enrollment ID: I20160210000633 |
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