Provider Demographics
NPI:1205063609
Name:DUSOLD, MOJCA (LPC)
Entity type:Individual
Prefix:MRS
First Name:MOJCA
Middle Name:
Last Name:DUSOLD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:MOJCA
Other - Middle Name:
Other - Last Name:BRANC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:807 W BROAD ST
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18018-5223
Mailing Address - Country:US
Mailing Address - Phone:610-419-9415
Mailing Address - Fax:610-419-9418
Practice Address - Street 1:807 W BROAD ST
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18018-5223
Practice Address - Country:US
Practice Address - Phone:610-419-9415
Practice Address - Fax:610-419-9418
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-12
Last Update Date:2020-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
PAPC008445101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health