MEDICARE: BILLIE JAELYN ANDERSON-PACHULSKI LICSW, MSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor

General Provider Information

NPI Number	:	1215183942
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BILLIE JAELYN ANDERSON-PACHULSKI LICSW, MSW

Provider Business Mailing Address
First Line	:	PO BOX 504
Second Line	:
City	:	SANDISFIELD
State	:	MA
Zip	:	01255-0504
Country	:	US
Telephone Number	:	413-652-0252
Fax Number	:

Provider Business Practice Location Address
First Line	:	51 CHURCH ST
Second Line	:
City	:	LENOX
State	:	MA
Zip	:	01240-2649
Country	:	US
Telephone Number	:	413-446-1525
Fax Number	:	413-637-4667

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/13/2008
Last Update Date	:	08/18/2019

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