Provider Demographics
NPI:1093967424
Name:BARDZILOWSKI, STEPHEN JUDE (LPC)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:JUDE
Last Name:BARDZILOWSKI
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:806 TUURI PL
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48503-2465
Mailing Address - Country:US
Mailing Address - Phone:810-767-5750
Mailing Address - Fax:810-768-7512
Practice Address - Street 1:806 TURRI PLACE
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48503
Practice Address - Country:US
Practice Address - Phone:810-767-5750
Practice Address - Fax:810-768-7512
Is Sole Proprietor?:No
Enumeration Date:2008-10-16
Last Update Date:2008-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401004134101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional