Provider Demographics
NPI:1790481059
Name:BILICH, JORDAN (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:JORDAN
Middle Name:
Last Name:BILICH
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 KATHY ANN LN
Mailing Address - Street 2:
Mailing Address - City:MC MURRAY
Mailing Address - State:PA
Mailing Address - Zip Code:15317-3200
Mailing Address - Country:US
Mailing Address - Phone:304-982-9618
Mailing Address - Fax:
Practice Address - Street 1:3000 PARK PLACE DR STE 108
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-2068
Practice Address - Country:US
Practice Address - Phone:412-435-4648
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-07
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0231451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical