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General NPI Number Information
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NPI Number | 1316480080
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Entity Type | Organization
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Legal Business Name | DENISE M. NOWACINSKI
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Dates
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Enumeration Date | 11/29/2016
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Last Update Date | 11/29/2016
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Provider Practice Location Address
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Address Line | 1353 W 6TH ST
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City | ERIE
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State | PA
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Zip | 16505-2503
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Country | US
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Telephone | 814-397-5430
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Fax |
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Provider Business Mailing Address
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Address Line | 1353 W 6TH ST
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City | ERIE
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State | PA
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Zip | 16505-2503
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Country | US
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Telephone | 814-397-5430
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. DENISE MICHELLE NOWACINSKI
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Credential | LPC
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Telephone | 814-397-5430
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | PC007560
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License Number State | PA
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