MEDICARE: HOLLY SUZANNE PILARSKI LISW-S, BCD

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	1041C0700X	Clinical Social Worker	I.1100211	OH

General Provider Information

NPI Number	:	1578851333
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HOLLY SUZANNE PILARSKI LISW-S, BCD

Provider Business Mailing Address
First Line	:	7552 HARMON RD
Second Line	:
City	:	CONNEAUT
State	:	OH
Zip	:	44030-3136
Country	:	US
Telephone Number	:	440-812-7204
Fax Number	:

Provider Business Practice Location Address
First Line	:	6441 SOUTH MAIN STREET
Second Line	:
City	:	NORTH KINGSVILLE
State	:	OH
Zip	:	44068-0501
Country	:	US
Telephone Number	:	440-812-7204
Fax Number	:

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

Provider Enumeration Date	:	07/14/2011
Last Update Date	:	08/01/2017

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