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NPI Code Detail

MEDICARE: BRYAN JACOB MICHALOWSKI LCSWA

MEDICARE: BRYAN JACOB MICHALOWSKI LCSWA
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
11041C0700XClinical Social WorkerP017023NC

General Provider Information

NPI Number : 1689127920
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRYAN JACOB MICHALOWSKI LCSWA
Provider Business Mailing Address
First Line : 200 RIVER MILL DR APT 307
Second Line :
City : ASHEVILLE
State : NC
Zip : 28803-0423
Country : US
Telephone Number : 734-395-3202
Fax Number :
Provider Business Practice Location Address
First Line : 322 8TH AVE E
Second Line :
City : HENDERSONVILLE
State : NC
Zip : 28792-3713
Country : US
Telephone Number : 828-708-7088
Fax Number : 828-800-9326
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/03/2016
Last Update Date : 06/03/2024

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