Rachel A. Lackovic, Lcsw Llc | |
807 W 26th St Suite 3 Erie PA 16508-3205 | |
(814) 873-5206 | |
(814) 461-0235 |
Full Name | Rachel A. Lackovic, Lcsw Llc |
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Speciality | Social Worker |
Location | 807 W 26th St, Erie, Pennsylvania |
Authorized Official Name and Position | Rachel Lackovic (CEO) |
Authorized Official Contact | 8148735206 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Rachel A. Lackovic, Lcsw Llc 807 W 26th St Suite 3 Erie PA 16508-3205 Ph: (814) 873-5206 | Rachel A. Lackovic, Lcsw Llc 807 W 26th St Suite 3 Erie PA 16508-3205 Ph: (814) 873-5206 |
NPI Number | 1912366782 |
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Provider Enumeration Date | 02/22/2016 |
Last Update Date | 08/04/2017 |
Medicare PECOS PAC ID | 0941508493 |
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Medicare Enrollment ID | O20160415001675 |
Identifier | Type | State | Issuer |
---|---|---|---|
1912366782 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | CW017250 (Pennsylvania) | Primary |
Provider Name | Rachel A Lackovic |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1255620449 PECOS PAC ID: 7810156528 Enrollment ID: I20120315000150 |
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