Provider Demographics
NPI:1578645883
Name:NAWROCKI, MADELYN ABRAM (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:MADELYN
Middle Name:ABRAM
Last Name:NAWROCKI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 397
Mailing Address - Street 2:
Mailing Address - City:RAINIER
Mailing Address - State:OR
Mailing Address - Zip Code:97048-0397
Mailing Address - Country:US
Mailing Address - Phone:503-739-1084
Mailing Address - Fax:
Practice Address - Street 1:2120 EXCHANGE ST
Practice Address - Street 2:STE 301
Practice Address - City:ASTORIA
Practice Address - State:OR
Practice Address - Zip Code:97103
Practice Address - Country:US
Practice Address - Phone:503-325-0241
Practice Address - Fax:503-325-8483
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL44511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001520146OtherHIGHMARK PIN
PA001520146OtherHIGHMARK PIN