=====================================================
General NPI Number Information
=====================================================
NPI Number | 1497813240
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | FLORENCE WILBIK MA, LPC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/05/2006
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2000 FOUNDATION WAY SUITE 3500
-----------------------------------------------------
City | MARTINSBURG
-----------------------------------------------------
State | WV
-----------------------------------------------------
Zip | 25401-9003
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 304-264-1442
-----------------------------------------------------
Fax | 304-264-4317
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2000 FOUNDATION WAY SUITE 3500
-----------------------------------------------------
City | MARTINSBURG
-----------------------------------------------------
State | WV
-----------------------------------------------------
Zip | 25401-9003
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 304-264-1442
-----------------------------------------------------
Fax | 304-264-4317
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | 1037
-----------------------------------------------------
License Number State | WV
-----------------------------------------------------