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Organization
GORECKI PSYCHOLOGICAL SERVICES LLC
Active
Organization
GORECKI PSYCHOLOGICAL SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIM MARIE GORECKI PSY.D. (OWNER/CLINICAL PSYCHOLOGIST)
(262) 546-7478
Entity
Organization
Contact information
Practice address
19275 W CAPITOL DR STE 200, BROOKFIELD, WI 53045-2734
(262) 546-7478
(262) 373-0362
Mailing address
19275 W CAPITOL DR STE 200, BROOKFIELD, WI 53045-2734
(262) 546-7478
(262) 373-0362
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1649361775
NPI
WI
01
—
2810-057
CP LICENSE
WI
Enumeration date
02/19/2019
Last updated
02/19/2019
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