Maciejko, Joseph S

Maciejko, Joseph S is an individual health care provider with primary practice located at 4455 E 56Th St , Davenport IA 52807-2995. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Maciejko, Joseph S can be contacted via phone (563) 355-2577.

Contact Information

Primary practice address
4455 E 56Th St Davenport IA 52807-2995
Phone: (563) 355-2577
Fax: (563) 355-4015
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 00085 Iowa
Behavioral Health & Social Service Providers / Psychologist 103T00000X 00240 Iowa
Behavioral Health & Social Service Providers / Psychologist 103T00000X Illinois

Profile Details

NPI number 1922096791
LBN Legal business name Maciejko, Joseph S
Credentials PH.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 6th, 2005
Last updated Jul 9th, 2007 - about 19 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1922096791 NPPES
Iowa Other 42652 WELLMARK HEALTH PLAN
Iowa MEDICAID 1083568 WELLMARK HEALTH PLAN
Iowa Other IA0195 WELLMARK HEALTH PLAN

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