Krecek, John Anthony
Krecek, John Anthony is an sole proprietor health care provider with primary practice located at 4218 W Western Ave , South Bend IN 46619-2622. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Krecek, John Anthony can be contacted via phone (574) 233-1524.Contact Information
Primary practice address
4218 W Western Ave
South Bend IN 46619-2622
Phone: (574) 233-1524
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 32436 | Illinois |
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | MATS-148 | Indiana |
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | CCJP-1005 | Indiana |
Profile Details
| NPI number | 1811388424 |
|---|---|
| LBN Legal business name | Krecek, John Anthony |
| Credentials | MA,CAADC, MATS, CCJP |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 18th, 2015 |
| Last updated | Jun 26th, 2015 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1811388424 | NPPES |
| Michigan | MEDICAID | 0 | |
| Michigan | MEDICAID | 0 |
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