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NPI Code Detail

MEDICARE: PATRICIA ANN LAZAREK LICSW

MEDICARE: PATRICIA ANN LAZAREK LICSW
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 Worker119158MA
21041C0700XClinical Social Worker119158MA

General Provider Information

NPI Number : 1487135661
Entity Type Code : Individual
Provider Name (Legal Business Name) : PATRICIA ANN LAZAREK LICSW
Provider Business Mailing Address
First Line : 1369 GRAFTON ST
Second Line :
City : WORCESTER
State : MA
Zip : 01604-2737
Country : US
Telephone Number : 508-373-7414
Fax Number : 508-373-7449
Provider Business Practice Location Address
First Line : 1369 GRAFTON ST
Second Line :
City : WORCESTER
State : MA
Zip : 01604-2737
Country : US
Telephone Number : 508-373-7414
Fax Number : 508-373-7449
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/24/2018
Last Update Date : 08/24/2018

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Directions to “ PATRICIA ANN LAZAREK LICSW” Practice Location

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