Doctor Name: | LEONARD ROBERT MIKULSKI |
NPI Number: | 1194942235 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | L.C.S.W. |
License Number: | 207186 |
Business Practice Address: | 13 Temple St 3rd Floor Quincy, MA - 021695110 |
Business Phone Number: | 6174718400 |
Business Fax Number: | |
Mailing Address: | 55 Florence Rd, WALTHAM |
State: | MA |
Postal Code: | 024531505 |
Phone Number: | 7818993242 |
Fax Number: | |
NPI Enumeration Date: | 04/19/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 207186 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | MA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |