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General NPI Number Information
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NPI Number | 1174960272
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Entity Type | Individual
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Provider Name | TANIA MARIE BIALECK MA, NCC, LPC
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Gender | Female
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Dates
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Enumeration Date | 05/29/2013
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Last Update Date | 01/11/2022
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Provider Practice Location Address
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Address Line | 207 S BROAD STREET SUITE 1
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City | MOORESVILLE
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State | NC
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Zip | 28115
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Country | US
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Telephone | 800-311-7072
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Fax | 704-621-7652
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Provider Business Mailing Address
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Address Line | 301 N CANTERBURY ROAD
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City | CHARLOTTE
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State | NC
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Zip | 28211
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Country | US
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Telephone | 704-621-7652
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | A8563
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 8563
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License Number State | NC
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