| Georgien Dudzek, Psy.d. Llc | |
|
111 N Main St Ste 100 Janesville WI 53545-3072 | |
| (608) 580-0031 | |
| (608) 580-0038 |
| Full Name | Georgien Dudzek, Psy.d. Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 111 N Main St Ste 100, Janesville, Wisconsin |
| Authorized Official Name and Position | Georgien D. Dudzek (OWNER / PSYCHOLOGIST) |
| Authorized Official Contact | 6085800031 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Georgien Dudzek, Psy.d. Llc 111 N Main St Ste 100 Janesville WI 53545-3072 Ph: (608) 580-0031 | Georgien Dudzek, Psy.d. Llc 111 N Main St Ste 100 Janesville WI 53545-3072 Ph: (608) 580-0031 |
| NPI Number | 1124746649 |
|---|---|
| Provider Enumeration Date | 08/19/2022 |
| Last Update Date | 10/07/2022 |
| Certification Date | 10/07/2022 |
| Medicare PECOS PAC ID | 3274900550 |
|---|---|
| Medicare Enrollment ID | O20221028001523 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124746649 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Georgien Dudzek |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1396167177 PECOS PAC ID: 6103120365 Enrollment ID: I20160624000103 |
| Provider Name | Loukia Alafogianis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548933013 PECOS PAC ID: 2860867157 Enrollment ID: I20230419002084 |
| Provider Name | Heidi Jo Rivera |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952601833 PECOS PAC ID: 2264880830 Enrollment ID: I20231121002587 |
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