Healthcare Provider Details

I. General information

NPI: 1710585757
Provider Name (Legal Business Name): ELIZABETH ANNE BILISOLY LCMHC, LCASA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/13/2020
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2530 MERIDIAN PKWY STE 115
DURHAM NC
27713-5273
US

IV. Provider business mailing address

PO BOX 4003
GASTONIA NC
28054-0041
US

V. Phone/Fax

Practice location:
  • Phone: 732-320-8380
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number26372
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberA17035
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number17035
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: