Provider Demographics
NPI:1578851333
Name:PILARSKI, HOLLY SUZANNE (LISW-S, BCD)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:SUZANNE
Last Name:PILARSKI
Suffix:
Gender:F
Credentials:LISW-S, BCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7552 HARMON RD
Mailing Address - Street 2:
Mailing Address - City:CONNEAUT
Mailing Address - State:OH
Mailing Address - Zip Code:44030-3136
Mailing Address - Country:US
Mailing Address - Phone:440-812-7204
Mailing Address - Fax:
Practice Address - Street 1:6441 SOUTH MAIN STREET
Practice Address - Street 2:
Practice Address - City:NORTH KINGSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44068-0501
Practice Address - Country:US
Practice Address - Phone:440-812-7204
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-14
Last Update Date:2017-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.11002111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical