Jessica Waclawski, LCSW
Individual provider Active NPI Clinical Social Worker · Eagle-Vail, CO
NPI 1235599507 · NPPES record last updated Mar 1, 2016
Key facts
- NPI
- 1235599507
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- Practice address
- 51 Eagle Rd
Eagle-Vail, CO 81620 - Phone
- (303) 717-0801
- NPI assigned
- Mar 1, 2016
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | CO | Yes |
Addresses
Primary practice location
51 Eagle Rd
Eagle-Vail, CO 81620
Mailing address
PO Box 1776
Avon, CO 81620-1776
Phone (303) 717-0801
Other providers in Eagle-Vail, CO
All providers in Eagle-Vail, CO · Clinical Social Worker in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 1, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.