Gorecki Psychological Services LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

GORECKI PSYCHOLOGICAL SERVICES LLC

Practice address

19275 W Capitol Dr Ste 200
Brookfield, WI 53045-2734

Phone

(262) 546-7478

Fax

(262) 373-0362

NPI assigned

Feb 19, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Kim Marie Gorecki, PSY.D.NPI 1649361775

Title

Owner/Clinical Psychologist

Phone

(262) 546-7478

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kim Marie Gorecki, PSYD

  • Clinical Psychologist
  • Brookfield, WI
  • NPI 1649361775
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1550534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550534400000",
    "number": "1083170732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19275 W CAPITOL DR STE 200",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530452734",
            "telephone_number": "262-546-7478",
            "fax_number": "262-373-0362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19275 W CAPITOL DR STE 200",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530452734",
            "telephone_number": "262-546-7478",
            "fax_number": "262-373-0362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GORECKI PSYCHOLOGICAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-19",
        "last_updated": "2019-02-19",
        "status": "A",
        "authorized_official_last_name": "GORECKI",
        "authorized_official_first_name": "KIM",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER/CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "262-546-7478",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1649361775",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CP LICENSE",
            "identifier": "2810-057",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Steven John Goll, PHARM D
• Lawrence A Golopol, MD
• Peter James Gonzalez, D.C.
• Serena Goodbear
• Emma Gooding
• Kim Marie Gorecki, PSYD
• Michael P Goss, MD
• Khushi Goyal
• Kathryn Gradecki
• Eva Graham

• Mental Health Clinic/Center (Including Community Mental Health Center) in Brookfield, WI
• Providers in Brookfield, WI by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.