| Rudolph Skowronski Lcsw Llc | |
|
110 Main St Suite 1306 Saco ME 04072-3509 | |
| (207) 571-3008 | |
| (207) 571-3263 |
| Full Name | Rudolph Skowronski Lcsw Llc |
|---|---|
| Speciality | Social Worker |
| Location | 110 Main St, Saco, Maine |
| Authorized Official Name and Position | Rudolph Albert Skowronski (PSYCHOTHERAPIST) |
| Authorized Official Contact | 2075713008 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rudolph Skowronski Lcsw Llc Po Box 551 Saco ME 04072-0551 Ph: (207) 571-3008 | Rudolph Skowronski Lcsw Llc 110 Main St Suite 1306 Saco ME 04072-3509 Ph: (207) 571-3008 |
| NPI Number | 1265506604 |
|---|---|
| Provider Enumeration Date | 11/18/2006 |
| Last Update Date | 10/28/2008 |
| Medicare PECOS PAC ID | 6507924784 |
|---|---|
| Medicare Enrollment ID | O20081016000050 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265506604 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | LC6729 (Maine) | Primary |
| Provider Name | Rudolph Albert Skowronski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386680858 PECOS PAC ID: 0143121285 Enrollment ID: I20040220000917 |
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