Provider Demographics
NPI:1184997504
Name:PLISKOW, NAOMI JOY (MA, NCC, LPC)
Entity type:Individual
Prefix:
First Name:NAOMI
Middle Name:JOY
Last Name:PLISKOW
Suffix:
Gender:F
Credentials:MA, NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1210 OLD YORK RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:WARMINSTER
Mailing Address - State:PA
Mailing Address - Zip Code:18974-2013
Mailing Address - Country:US
Mailing Address - Phone:215-444-9204
Mailing Address - Fax:
Practice Address - Street 1:1210 OLD YORK RD
Practice Address - Street 2:SUITE 202
Practice Address - City:WARMINSTER
Practice Address - State:PA
Practice Address - Zip Code:18974-2013
Practice Address - Country:US
Practice Address - Phone:215-444-9204
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-15
Last Update Date:2015-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0023701OtherAGENCY MEDICAID PROVIDER NUMBER