Provider Demographics
NPI:1518370725
Name:PILECKI, DALLAS (MED LMHC)
Entity Type:Individual
Prefix:
First Name:DALLAS
Middle Name:
Last Name:PILECKI
Suffix:
Gender:M
Credentials:MED LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 TANNERY RD
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01085-4822
Mailing Address - Country:US
Mailing Address - Phone:413-977-3495
Mailing Address - Fax:413-977-3495
Practice Address - Street 1:104 TANNERY RD
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:MA
Practice Address - Zip Code:01085-4822
Practice Address - Country:US
Practice Address - Phone:413-977-3495
Practice Address - Fax:413-977-3495
Is Sole Proprietor?:No
Enumeration Date:2014-06-05
Last Update Date:2018-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health