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NPI Code Detail

MEDICARE: GEORGE MONTY SABOLCIK SR. LCSW

MEDICARE: GEORGE MONTY SABOLCIK SR. LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker007523CT
21041C0700XClinical Social Worker007523CT
31041S0200XSchool Social Worker6769973690CT

General Provider Information

NPI Number : 1164872586
Entity Type Code : Individual
Provider Name (Legal Business Name) : GEORGE MONTY SABOLCIK SR. LCSW
Provider Business Mailing Address
First Line : PO BOX 610
Second Line :
City : LITCHFIELD
State : CT
Zip : 06759-0610
Country : US
Telephone Number : 860-567-9423
Fax Number : 860-567-8127
Provider Business Practice Location Address
First Line : 550 GOSHEN RD
Second Line :
City : LITCHFIELD
State : CT
Zip : 06759-2405
Country : US
Telephone Number : 860-567-9423
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2016
Last Update Date : 06/16/2016

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Directions to “ GEORGE MONTY SABOLCIK SR. LCSW” Practice Location

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