| Regina Kujawa Lcsw Pllc | |
|
1175 Revolution Mill Dr Ste 29-2 Greensboro NC 27405-5079 | |
| (336) 554-3291 | |
| Not Available |
| Full Name | Regina Kujawa Lcsw Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 1175 Revolution Mill Dr Ste 29-2, Greensboro, North Carolina |
| Authorized Official Name and Position | Regina Kujawa (OWNER) |
| Authorized Official Contact | 3365543291 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Regina Kujawa Lcsw Pllc 5603b W Friendly Ave # 256 Greensboro NC 27410-4213 Ph: (336) 554-3291 | Regina Kujawa Lcsw Pllc 1175 Revolution Mill Dr Ste 29-2 Greensboro NC 27405-5079 Ph: (336) 554-3291 |
| NPI Number | 1760134316 |
|---|---|
| Provider Enumeration Date | 01/25/2022 |
| Last Update Date | 01/25/2022 |
| Certification Date | 01/25/2022 |
| Medicare PECOS PAC ID | 0648667022 |
|---|---|
| Medicare Enrollment ID | O20220504000811 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760134316 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Regina G Kujawa |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447428693 PECOS PAC ID: 9234198458 Enrollment ID: I20181203002766 |
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