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General NPI Number Information
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NPI Number | 1467084673
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Entity Type | Individual
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Provider Name | CONSTANCE JOY BIENKOWSKI LPC
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Gender | Female
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Dates
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Enumeration Date | 02/05/2020
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Last Update Date | 02/05/2020
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Provider Practice Location Address
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Address Line | 4865 MARKET ST
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City | PHILADELPHIA
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State | PA
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Zip | 19139-3508
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Country | US
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Telephone | 484-704-0688
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Fax |
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Provider Business Mailing Address
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Address Line | 110 4TH AVE APT 7
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City | ROEBLING
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State | NJ
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Zip | 08554-1012
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Country | US
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Telephone | 856-630-6261
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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 | PC011369
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License Number State | PA
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