| Nicole Iacovoni, LCSW, MSW | |
|
214 Center St, Bloomsburg, PA 17815-1752 | |
| (570) 336-9921 | |
| Not Available |
| Full Name | Nicole Iacovoni |
|---|---|
| Gender | Female |
| Speciality | Social Worker - Clinical |
| Location | 214 Center St, Bloomsburg, Pennsylvania |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578834784 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | CW017138 (Pennsylvania) | Primary |
| Entity Name | Willow Tree Wellness & Counseling Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1649521584 PECOS PAC ID: 6103275508 Enrollment ID: O20231211002386 |
| Mailing Address | Practice Location Address |
|---|---|
| Nicole Iacovoni, LCSW, MSW 214 Center St, Bloomsburg, PA 17815-1752 Ph: (570) 336-9921 | Nicole Iacovoni, LCSW, MSW 214 Center St, Bloomsburg, PA 17815-1752 Ph: (570) 336-9921 |
Michael Spears, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 549 Fair St, Bloomsburg, PA 17815 Phone: 570-387-2432 | |
Ardie Kissinger, Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 457 Ridge St, Bloomsburg, PA 17815 Phone: 570-356-2206 | |
Charles Guy Massaro, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 29 E Main St, Bloomsburg, PA 17815 Phone: 570-951-6799 | |
Marika Handakas, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 141 Market St, Bloomsburg, PA 17815 Phone: 570-387-8330 | |
Ms. Trudy L Frace, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 816 Central Rd, Bloomsburg, PA 17815 Phone: 570-387-1832 Fax: 570-387-5103 | |
Cindy A Prosseda, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 6850 Lowes Road, Bloomsburg, PA 17815 Phone: 570-772-3372 |