Provider Demographics
NPI:1073947578
Name:BILSKI, MICHELLE VENEE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:VENEE
Last Name:BILSKI
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:142 N MAIN ST
Mailing Address - Street 2:PO BOX 918
Mailing Address - City:MOSCOW
Mailing Address - State:PA
Mailing Address - Zip Code:18444-9149
Mailing Address - Country:US
Mailing Address - Phone:570-780-5004
Mailing Address - Fax:570-457-0189
Practice Address - Street 1:142 N MAIN ST
Practice Address - Street 2:
Practice Address - City:MOSCOW
Practice Address - State:PA
Practice Address - Zip Code:18444-9149
Practice Address - Country:US
Practice Address - Phone:570-780-5004
Practice Address - Fax:570-457-0189
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-03
Last Update Date:2015-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC007082101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional