| Stanhospodlcsw Llc | |
|
8 W Main St Niantic CT 06357-2303 | |
| (860) 377-3838 | |
| Not Available |
| Full Name | Stanhospodlcsw Llc |
|---|---|
| Speciality | Social Worker |
| Location | 8 W Main St, Niantic, Connecticut |
| Authorized Official Name and Position | Stanley Hospod (LCSW) |
| Authorized Official Contact | 8603773838 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Stanhospodlcsw Llc Po Box 226 Hanover CT 06350-0226 Ph: (860) 377-3838 | Stanhospodlcsw Llc 8 W Main St Niantic CT 06357-2303 Ph: (860) 377-3838 |
| NPI Number | 1538825658 |
|---|---|
| Provider Enumeration Date | 11/12/2021 |
| Last Update Date | 11/12/2021 |
| Certification Date | 11/12/2021 |
| Medicare PECOS PAC ID | 3375924707 |
|---|---|
| Medicare Enrollment ID | O20220718000885 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538825658 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Stanley Hospod |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457663841 PECOS PAC ID: 2567873649 Enrollment ID: I20201120001207 |
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