| Victoria Michalek, Llc | |
|
14 Depot Pl Fl 1 Bethel CT 06801-2540 | |
| (475) 289-4824 | |
| (475) 282-3442 |
| Full Name | Victoria Michalek, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 14 Depot Pl Fl 1, Bethel, Connecticut |
| Authorized Official Name and Position | Victoria Michalek (OWNER) |
| Authorized Official Contact | 2036482886 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Victoria Michalek, Llc 148 Middle River Rd Danbury CT 06811-4339 Ph: (203) 648-2886 | Victoria Michalek, Llc 14 Depot Pl Fl 1 Bethel CT 06801-2540 Ph: (475) 289-4824 |
| NPI Number | 1841703634 |
|---|---|
| Provider Enumeration Date | 11/15/2017 |
| Last Update Date | 11/05/2018 |
| Medicare PECOS PAC ID | 5799039921 |
|---|---|
| Medicare Enrollment ID | O20181107000387 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841703634 | NPI | - | NPPES |
| D300245896 | Medicaid | CT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 007931 (Connecticut) | Primary |
| Provider Name | Victoria Michalek |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396001707 PECOS PAC ID: 1052629722 Enrollment ID: I20150929002268 |
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