GORECKI PSYCHOLOGICAL SERVICES LLC NPI 1083170732

NPI Information

NPI: 1083170732
Provider Name: GORECKI PSYCHOLOGICAL SERVICES LLC
Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

Address:
19275 W CAPITOL DR STE 200
BROOKFIELD, WI
ZIP 53045
Phone: (262) 546-7478
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GORECKI PSYCHOLOGICAL SERVICES LLC is a mental health (including community mental health center) clinic center in Brookfield, WI. GORECKI PSYCHOLOGICAL SERVICES LLC NPI is 1083170732. The provider is registered as an organization entity type.

The provider's business location address is:

19275 W CAPITOL DR STE 200
BROOKFIELD, WI
ZIP 53045-734
Phone: (262) 546-7478
Fax: (262) 373-0362

The provider's authorized official is Kim Marie Gorecki .
The authorized official title is Owner/clinical Psychologist and has the following contact phone number (262) 546-7478.

The enumeration date for this NPI number is 2/19/2019 and was last updated on 2/19/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1649361775	OTHER	WISCONSIN	NPI
2	2810-057	OTHER	WISCONSIN	CP LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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