Provider Demographics
NPI:1134378979
Name:MICHALOSKI WILSON & ASSOC LLC
Entity type:Organization
Organization Name:MICHALOSKI WILSON & ASSOC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT/PSYCHOTHERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:J
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:BLA, MS, NCC, LCPC
Authorized Official - Phone:410-882-0470
Mailing Address - Street 1:8815 ALNWICK RD
Mailing Address - Street 2:
Mailing Address - City:BALTO
Mailing Address - State:MD
Mailing Address - Zip Code:21234
Mailing Address - Country:US
Mailing Address - Phone:410-882-7820
Mailing Address - Fax:
Practice Address - Street 1:204 E. JOPPA RD
Practice Address - Street 2:SUITE LL8
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21286
Practice Address - Country:US
Practice Address - Phone:410-882-0470
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-17
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC46804101Y00000X
MDLC0034101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDLL09M1OtherBLUE CROSS/SHIELD OF MD