Provider Demographics
NPI:1972821536
Name:NIECIKOWSKI, DAGMARA K (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:DAGMARA
Middle Name:K
Last Name:NIECIKOWSKI
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 1:33 RENN LN
Mailing Address - Street 2:
Mailing Address - City:BERLIN
Mailing Address - State:CT
Mailing Address - Zip Code:06037-3589
Mailing Address - Country:US
Mailing Address - Phone:860-748-5644
Mailing Address - Fax:
Practice Address - Street 1:45 RUSSELL ST
Practice Address - Street 2:
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06052-1312
Practice Address - Country:US
Practice Address - Phone:860-348-3371
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-06
Last Update Date:2019-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0070051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical